Document Detail

Pattern of use of β-blockers in older patients with stable coronary artery disease: an observational, cross-sectional, multicentre survey.
MedLine Citation:
PMID:  21913736     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Several drugs, including β-blockers (β-adrenoceptor antagonists), are largely under-utilized in older patients with cardiovascular disease.
OBJECTIVES: The aims of this study were to evaluate whether older patients (aged ≥65 years) with coronary artery disease (CAD) have a different pattern of use of β-blockers than younger adult patients (aged <65 years) and whether gender differences or other clinical variables may influence the use of these drugs.
METHODS: Over 6 months, 2226 outpatients with stable CAD were enrolled in an observational, cross-sectional, multicentre survey. Of these, 1416 patients aged ≥65 years were grouped into four subgroups according to age. Predictors of β-blocker use were determined using logistic regression analyses. Comparisons between younger adults and older patients were conducted using Student's t-tests and chi-squared (χ2) tests.
RESULTS: Up to 47% of older patients were not receiving β-blockers, and this percentage progressively increased with age, with the oldest patients showing the lowest rate of utilization. No gender difference in the pattern of use of β-blockers was noted. The prescription of β-blockers was higher in patients with heart failure (HF) than in patients without HF. The presence of HF abolished the decrease in β-blocker use with age. Logistic regression analysis confirmed that lower age and severe HF were independent predictors of β-blocker use in older people.
CONCLUSIONS: Age appears to be a key factor in the under-prescription of β-blockers in CAD outpatients. Despite the recommendations, and the efforts of cardiologists, the use of β-blockers in the elderly is still limited, possibly because of practical constraints such as adverse effects and co-morbidity. In patients with HF, age is less important in determining the use of β-blockers.
Cristiana Vitale; Ilaria Spoletini; Maurizio Volterrani; Ferdinando Iellamo; Massimo Fini
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Drugs & aging     Volume:  28     ISSN:  1170-229X     ISO Abbreviation:  Drugs Aging     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-14     Completed Date:  2012-05-04     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9102074     Medline TA:  Drugs Aging     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  703-11     Citation Subset:  IM    
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MeSH Terms
Adrenergic beta-Antagonists / pharmacology,  therapeutic use*
Age Factors
Coronary Artery Disease / drug therapy*,  pathology,  physiopathology
Cross-Sectional Studies
Data Collection*
Heart Rate / drug effects
Middle Aged
Reg. No./Substance:
0/Adrenergic beta-Antagonists

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

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