Abstract
Overview: Acute decompensated heart failure is a severe condition characterized by the rapid onset of heart failure symptoms, often exacerbated by hypertension. This condition is commonly seen in the elderly. Objective: Evaluate the effectiveness of SGLT2 inhibitors in elderly patients with acute decompensated heart failure and hypertension. Research subjects and methods: Prospective study with follow-up during hospital stay and 1 month after discharge in patients hospitalized with acute decompensated heart failure without contraindications to using Dapagliflozin, from November 2022 until July 2023. Results: Among 161 patients participating in the study, 106 patients agreed to be treated with Dapagliflozin 10mg combined with optimal medical treatment. At the hospital, patients using Dapagliflozin had symptom improvement 5 days earlier (p=0.038) compared to the group of patients not using Dapagliflozin. The rate of severe disease requiring use of vasopressors or transfer to the intensive care unit or death tends to be higher in the group of patients not using Dapagliflozin. The group of patients receiving medical treatment alone increased the risk of low blood pressure compared to the group of patients combined with Dapagliflozin (p<0.001). Follow-up 1 month after discharge, the readmission rate was significantly higher in the group of patients who did not use Dapagliflozin 10mg (p<0.001). There were no significant differences in common side effects in patients using SGLT2i in the two patient groups. Conclusion: SGLT2i treatment has been shown to be more effective in controlling acute decompensated heart failure with hypertension in elderly compared to those who only receive optimal medical treatment without increasing the risk of side effects.