Factors Influencing the Prognosis of Survival and Development of Cardiovascular Complications in Elderly Patients

Abstract

Background: Cardiovascular diseases are the leading cause of morbidity and mortality among elderly individuals, with prevalence increasing with age. In older patients, cardiovascular diseases rarely occur as isolated conditions, and their prognosis is determined by a combination of classical risk factors, geriatric syndromes, comorbid conditions, and behavioral factors.
Objective: To analyze factors influencing survival and the prognosis of cardiovascular complications in elderly patients with degenerative changes in the cardiovascular system.
Materials and Methods: The study included 200 patients aged 60 to 85 years (109 men, 81 women), divided into two groups: Group 1 (n=120) with degenerative valvular changes (aortic stenosis, mitral regurgitation, combined valvular lesions), and Group 2 (n=80) with atherosclerotic vascular changes (carotid artery stenosis, chronic limb ischemia, coronary artery disease). Statistical analysis included chi-square testing, Kaplan–Meier survival analysis, and Cox proportional hazards regression.
Results: In Group 1, arterial hypertension was observed in 81.6% (χ²=32.4; p<0.001), atherosclerosis in 60.0% (χ²=18.7; p=0.002), type 2 diabetes mellitus in 40.8% (χ²=9.3; p=0.026), dyslipidemia in 55.0% (χ²=14.8; p=0.008), and smoking in 31.6% (χ²=6.7; p=0.041). In Group 2, atherosclerosis was observed in 80.0%, arterial hypertension in 76.2%, dyslipidemia in 52.5%, type 2 diabetes mellitus in 47.5%, smoking in 33.8%, and chronic kidney disease in 23.8%. Combined risk factors occurred in 75% of Group 2 patients. Kaplan–Meier analysis showed survival rates of 60% in Group 1 and 75% in Group 2. Cox regression identified coronary artery calcification, arterial hypertension, metabolic disorders, and low treatment adherence as independent predictors of adverse outcomes.
Conclusion: Prognosis of survival and cardiovascular complications in elderly patients depends on classical risk factors, geriatric syndromes, comorbid conditions, and human-related factors. Low treatment adherence significantly increases complication risk even in patients with similar clinical profiles. A comprehensive, individualized approach incorporating both biomedical and behavioral factors is essential for improving outcomes in this population.