Effects of treatment with ACE inhibitors in elderly pacients with myocardial ischemia
Abstract Title: | Effects of treatment with ACE inhibitors in elderly pacients with myocardial ischemia |
Authors: | Ioana Dana Alexa, Bogdan Alexandroaie, Adrian Covic |
Affiliation: | University of Medicine and Pharmacy “Gr. T. Popa” Iasi Internal Medicine and Geriatric Department, “Dr. C. I. Parhon” Hospital, Iasi |
Abstract text: | Ischemic nephropathy is a frequent cause of chronic kidney disease in elderly patients with myocardial ischemia and is greatly underestimated. In most of the cases the diagnosis is established due to ACE inhibitors’ side effects on renal function during treatment for chronic ischemic heart disease. Our study evaluates the prevalence of ischemic nephropathy in elderly patients with chronic coronary disease treated with or without ACE inhibitors. A retrospective study of 45 patients aged 65 years admitted in the Geriatric Department of “Dr. C.I. Parhon Hospital” for cardiovascular diseases (CDV) was conducted. Patients’ distribution according to age was: 30 patients aged between 65-69 years and 15 patients aged between 70-75 years. Nephropathy ischemia diagnosis was based on following criteria: renal artery stenosis confirmed by Doppler ultrasonography and decrement of creatinine clearance (Cl Cr) over 30% after introducing treatment with ACE inhibitors. We excluded from our study the patients with concomitant diabetes mellitus or chronic kidney disease. Our data identified ischemic nephropathy in 78% of patients aged between 65-69 and in 83 % patients aged over 70 (Table 1). There were no significant differences related to the gender or style of life of the patients. The presence of ischemic nephropathy was correlated with concomitant metabolic syndrome and isolated systolic arterial hypertension. Elderly patients with chronic ischemic heart disease have high risk of ischemic nephropathy. This association is extremely important to recognize when recommending treatment with ACE inhibitors due to possible side effects on renal function. Monitoring renal function is essential in these cases. |
Keywords: | ACE inhibitors, myocardial ischemia, elderly |
Presentation type: | Oral |
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