Atherosclerotic cardiovascular disease and type 2 diabetes mellitus in elderly patients: risk management (review)

Atherosclerotic cardiovascular diseases (ASCVD) account for nearly half of all deaths in the Russian Federation. In a considerable number of cases, elderly patients have concomitant ASCVD and type 2 diabetes mellitus (T2DM), with ASCVD being the primary cause of death in patients with T2DM. The presence of shared risk factors and the presence of close pathophysiological relationships among these diseases suggests the potential for therapeutic action on both T2DM and ASCVD simultaneously. The therapeutic approach for type 2 diabetes mellitus (T2DM) in elderly patients with atherosclerotic cardiovascular disease (ASCVD) is a complex task due to changes in the functional and psychosocial status of patients, comorbidities, and polypharmacy. Therefore, the selection of therapeutic interventions for these patients requires an individualized approach. Presently, the selection of hypoglycemic medications is informed by their impact on cardiovascular outcomes and the safety profile with respect to hypoglycemia, a consideration of particular significance for elderly and senile patients. The review methodically analyzes current literature data on drugs for the treatment of elderly patients with ASCVD and T2DM, providing a concise overview of the mechanisms of action and the evidence base for their efficacy and safety. The objective of this information is to facilitate treatment decisions for patients with T2DM and ASCVD, including elderly and geriatric patients, within the context of routine clinical practice.

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