Page 7 - Seniorstoday June 2022 Issue
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The BP should be periodically checked Close attention to BP, Blood Sugar
using a digital home apparatus. The BP (Diabetes) and Lipids will go a long way in
should be less than 140/90 mm Hg for any slowing down the ravages of senescence.
senior citizen. If higher, medical advice and
treatment should be sought. Maintaining Ageing and malfunction of the Heart
a normal BP will considerably reduce the Muscle:
risk of strokes, heart attacks and heart and Ageing causes a general failure of energy
kidney failure. utilisation in the body and thus in the
It is necessary to check for Diabetes. heart it first causes impaired relaxation of
The best diagnostic test is a Glycosylated the heart leading to relaxation or diastolic
Hemoglobin (HbA1c) level in the blood. heart failure (HFpEF) - heart failure with
It is an accurate estimate of the average preserved ejection fraction.
blood sugar over the preceding 3 months. Symptoms such as breathlessness
Its level should be 6.5% or less. If higher and swelling of the feet may be seen. A
then treatment is necessary starting with thorough evaluation, including the use of
life style modifications of diet and exercise, Two Dimensional Echocardiography, will
drugs like SGLT2 inhibitors , Metformin reveal the diagnosis and this can be treated
and other medicines will be prescribed as with medication.
required. It is recommended that every A more serious situation arises when the
diabetic patient should take an SCLT2 heart muscle is damaged by heart attacks,
inhibitor, if not contraindicated, as these uncontrolled hypertension, diabetes and
drugs offer very significant protection to other disorders. The underlying cause
the heart, kidneys and the brain. needs to be identified and appropriate
A close watch should also be kept on the treatment instituted. A Two dimensional
Lipid Profile. The Total Cholesterol should Echocardiogram will reveal a low ejection
be around 150 mg%, the LDL or “bad” fraction of less than 40 %—( HFrEF;
cholesterol should be around 100 mg%, — heart failure with reduced ejection
the HDL “good” cholesterol should be more fraction).
than 45 mg% and the Triglycerides below To support the heart muscle there are
150 mg%. These levels are for those seniors excellent new drugs available (ARNI and
without established CVS disease. Those SGLT2i) In certain cases one may consider,
with disease need still tighter control with when appropriate, valve replacement,
LDLC levels as low as 55 mg%. cardiac re-synchronisation therapy and
These levels can only be achieved with a heart transplant where appropriate.
combination of diet, exercise and Statins. With periodic evaluation and appropriate
There are many misgivings about the life style modification and treatment, a very
side effects of statins. Suffice it to say that significant number of heart failure cases
Statins are “life savers”, as they not only can be adequately treated.
reduce cholesterol to target levels but also
have a host of salutary effects on the blood Ageing of the Heart Valves:
vessel wall. They undoubtedly reduce heart The normal heart valves are thin and
attacks and strokes and every senior should pliable. They allow unidirectional flow of
take a statin if he has CVS disease. blood. With advancing age they become
SENIORS TODAY | ISSUE #36 | JUNE 2022 7
