Features of clinical approaches to managing patients with senile asthenia
Tkacheva O.N.^1,2, Kotovskaya Yu.V.^1,3, Runikhina N.K.^1,2, Ostapenko V.S.<sup>1,3

1</sup> Russian gerontological scientific and clinical center, Moscow
² Russian National Research Medical University named after N.I. Pirogov, Moscow
³ Peoples' Friendship University of Russia, Moscow

To reduce the risk of cardiovascular morbidity and mortality in middle-aged patients, it is important to control arterial hypertension, dyslipidemia, and glycemia in accordance with current recommendations of the scientific community. Patients over 75-80 years old make up the most fast growing part of the population, but they are rarely included into randomized clinical trials, that makes a problem for a direct application of the existing clinical recommendations for the prevention of cardiovascular disease to this category of patients. In addition, these patients often have accumulated functional deficits, the senile asthenia syndrome, polymorbidity, which often has a greater impact on prognosis than traditional risk factors, as well as high exposure to undesirable phenomena due to changes in pharmacokinetics and pharmacodynamics of the drugs, and because of the appointment of a large number of medicines (polypharmacy). It must be admitted that we have the limited knowledge of how to optimally use the approaches to the prevention of cardiovascular diseases, the effectiveness of which has been proved in younger people. It is necessary for the physicians managing the elderly patients to develop the skills of the management of senile asthenia and the implementation of geriatric approaches in cooperation with geriatric physicians.

Key words: primary prevention, aging, senile asthenia, arterial hypertension, dyslipidemia, diabetes mellitus, multimorbidity.
For citation: Tkacheva O.N., Kotovskaya Yu.V., Runikhina N.K., Ostapenko V.S. Features of clinical approaches to managing patients with senile asthenia // RMJ.  2017. № 25. P. 1823–1825.