Document Detail


Cardiovascular drug therapy in the elderly: benefits and challenges.
MedLine Citation:
PMID:  20978470     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Increasing life expectancy in industrialized societies has resulted in a huge population of older adults with cardiovascular disease. Despite advances in device therapy and surgery, the mainstay of treatment for these disorders remains pharmacological. Hypertension affects two-thirds of older adults and remains a potent risk factor for coronary artery disease, chronic heart failure, atrial fibrillation, and stroke in this age group. Numerous trials have demonstrated reduction in these adverse outcomes with antihypertensive drugs. After acute myocardial infarction, β-adrenergic blockers reduce mortality regardless of patient age. Statins and antiplatelet drugs have proven beneficial in both primary and, especially, secondary prevention of coronary events in older adults. In elders with chronic heart failure, loop diuretics must be used cautiously, owing to their higher potential for adverse effects, whereas angiotensin-converting-enzyme inhibitors and β-blockers reduce symptoms and prolong survival. The high risk of stroke in elderly patients with atrial fibrillation is markedly reduced with warfarin, although bleeding risk is increased. The high prevalence of polypharmacy among older adults with cardiovascular disease, coupled with age-associated physiological changes and comorbidities, provides major challenges in adherence and avoidance of drug-related adverse events.
Authors:
Jerome L Fleg; Wilbert S Aronow; William H Frishman
Publication Detail:
Type:  Journal Article; Review     Date:  2010-10-26
Journal Detail:
Title:  Nature reviews. Cardiology     Volume:  8     ISSN:  1759-5010     ISO Abbreviation:  Nat Rev Cardiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-20     Completed Date:  2011-04-04     Revised Date:  2011-07-19    
Medline Journal Info:
Nlm Unique ID:  101500075     Medline TA:  Nat Rev Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  13-28     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Bethesda, MD 20892, USA. flegj@nhlbi.nih.gov
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aging*
Cardiovascular Agents / adverse effects,  therapeutic use*
Cardiovascular Diseases / drug therapy*
Evidence-Based Medicine
Female
Humans
Male
Middle Aged
Patient Selection
Risk Assessment
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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