Vnitr Lek 2011, 57(6):561-570
Seniors and cardiovascular medications
- Klinika interní, geriatrie a praktického lékařství Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednostka prof. MUDr. Hana Matějovská Kubešová, CSc.
Authors analyze the situation in the therapy of cardiovascular diseases - unsatisfactory situation especially from the dyslipidaemia point of view. Different groups of medications are discussed and their risks for elderly patients. Angiotensin converting enzyme blockers and their influence on the endothelial dysfunction, but the risk of hyperpotassemia are showed. The risk of gastrointestinal bleeding during the treatment with antiagregants and anticoagulants, the risk of bradycardia in beta-blockade, possible interactions with other medications lowering the heart rate are discussed. Attention is paid to calcium channel blockers, diuretics and digoxin. The table containing possible clinical symptoms of unwanted sideefect of most frequently used cardiovascular medications in elderly is added as the conclusion of the article.
Keywords: angiotensin converting enzyme inhibitors; antiagregants; beta-blockers; statins; calcium blockers; diuretics; digoxin; pharmacotherapy in elderly; unwanted side effects; interaction of medications
Accepted: January 26, 2011; Published: June 1, 2011 Show citation
References
- Kalvach Z, Zadák Z, Jirák R et al. Geriatrie a gerontologie. 1. vyd. Praha: Grada 2004.
- Topinková E. Geriatrie pro praxi. Praha: Galén 2005.
- Fialová D, Topinková E, Gambassi G et al. Potentially Inappropriate Medication Use Among Elderly Home Care Patients in Europe. JAMA 2005; 293: 1348-1358.
Go to original source...
Go to PubMed...
- Kubešová H, Holík J, Šipr K et al. Odraz vědeckých poznatků v preskripci praktického lékaře. Prakt Lék 2000; 80: 509-513.
- Kubešová H, Holík J, Weber P et al. Spotřeba léčiv v seniorské populaci a rizika polyfarmakoterapie ve stáří. Čas Lék Čes 2006; 9: 708-712.
- Zed PJ, Abu-Laban RJ, Balen RM. Incidence, severity and preventability of medication-related visits to emergency department: a prospective study. CMAJ 2008; 178: 1563-1569.
Go to original source...
Go to PubMed...
- Beers MH, Ouslander JG, Rollingher I et al. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Arch Intern Med 1991; 151: 1825-1832.
Go to original source...
- Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly: an update. Arch Intern Med 1997; 157: 1531-1536.
Go to original source...
- Matějovský J. Komplexní pohled na funkční a zdravotní stav seniorů žijících ve svém vlastním prostředí. Diplomová práce, Lékařská fakulta, Masarykova univerzita 2007.
- Hemmelgarn BR, Chen G, Walker R et al. Trends in antihypertensive drug prescriptions and physician visits in Canada between 1996 and 2006. Can J Cardiol 2008; 24: 507-512.
Go to original source...
Go to PubMed...
- Blakley BW, Gulati H. Identifying drugs that cause dizziness. J Otolaryngol 2008; 37: 11-15.
- Konopa J, Bullo B, Rutkowski B. Life threatening drug-induced hyperkaliemia - case report. Pol Arch Med Wewm 2006; 115: 238-242.
- Pilote L, Abrahamovicz M, Eisenberg M et al. Effect of different angiotensin-converting enzyme inhibitors on mortality among elderly patients with congestive heart failure. CMAJ 2008; 178: 1303-1311.
Go to original source...
Go to PubMed...
- Masunari N, Fujiwara S, Nakata Y et al. Effect of angiotensin converting enzyme inhibitor and benzodiazepine intake on bone loss in older Japanese. Hiroshima J Med Sci 2008; 57: 17-25.
- Flammer AJ, Sudano I, Hermann F et al. Angiotensin converting enzyme inhibition improves vascular function in rheumatoid artritis. Circulation 2008; 117: 2262-2269.
Go to original source...
Go to PubMed...
- Werner C, Baumhäkel M, Teo KK et al. RAS blockade with ARB and ACE inhibitors: current perspective on rationale and patients selection. Clin Res Cardiol 2008; 97: 481-431.
Go to original source...
Go to PubMed...
- Doporučení České kardiologické společnosti pro diagnostiku a léčbu srdečního selhání ČKS 2006. Cor et Vasa 2007; 49: K5-K34.
- Kahn R, Robertson RM, Smith R et al. The impact of prevention on reducing the burden of cardiovasculat disease. Circulation 2008; 118: 576-585.
Go to original source...
Go to PubMed...
- Vekasi J, Koltai K, Gaal V et al. The effect of aspirin on hemoreological parameters of patients with diabetic retinopathy. Clin Hemorheol Microcirc 2008; 39: 385-389.
Go to original source...
- Juby AG, Davis P. Utility of published guidelines on the use of nonsteroidal antiinflammatory drugs in the elderly. Clin Rheumatol 2008; 27: 1191-1194.
Go to original source...
Go to PubMed...
- Arvanitakis Z, Grodstein F, Bienias JL et al. Relation of NSAIDs to incident AD, change in cognitive function, and AD patology. Neurology 2008; 70: 2219-2225.
Go to original source...
Go to PubMed...
- Szekely CA, Green RC, Breitner JC et al. No advantage of A beta 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies. Neurology 2008; 70: 2291-2298.
Go to original source...
Go to PubMed...
- Vojáček J. Výsledky stuide RE-LY slibují účinnější, bezpečnější a jednodušší prevenci embolických komplikací u nemocných s nevalvulární fibrilací síní. Vnitř Lék 2009; 55: 1085-1088.
Go to PubMed...
- Gallagher AM, Rietbrock S, Plomb J et al. Initiation and persistence of warfarin or aspirin in patients with chronic atrial fibrillation in general practice: do the appropriate patients receive stroke prophylaxis? J Throm Haemost 2008; 6: 1500-1506.
Go to original source...
Go to PubMed...
- European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31: 2369-2429.
Go to original source...
Go to PubMed...
- Onalan O, Cumurcu BE, Bekar L et al. Complete atrioventricular block associated with concomitant use of metoprolol and paroxetine. Mayo Clin Proc 2008; 83: 595-599.
Go to original source...
- Aströlm-Lilja C, Odeberg JM, Ekman E et al. Drug-induces torsades de pointes: a review of the Swedish pharmacovigilance database. Pharmacoepidemiol Drug Saf 2008; 17: 587-592.
Go to original source...
Go to PubMed...
- Galinier M, Emeriau JP. Prescribing beta blockers in elderly patients with heart failure. Presse Med 2008; 37: 1047-1054.
Go to original source...
Go to PubMed...
- Cleland JG, Coletta AP, Torabi A et al. Clinical trials update from the European Society of Cardiology heart failure meeting 2009: CHANCE, B-Convinced, CHAT, CIBIS-ELD and Signal HF. Eur J Heart Fail 2009; 11: 802-805.
Go to original source...
Go to PubMed...
- Rector TS, Anand IS, Nelson DB et al. Carvedilol versus controlled-release metoprolol for elderly veterans with heart failure. J Am Geriatr Soc 2008; 56: 1021-1027.
Go to original source...
Go to PubMed...
- Kubešová H, Weber P, Kala P et al. Akutní koronární syndrom u seniorů. Čes Ger Rev 2008; 6: 41-46.
- Zgažarová S, Jedličková H, Vašků V. Nežádoucí účinky amiodaronu na kůži. Vnitř Lék 2009; 55: 976-980.
Go to PubMed...
- Manderbacka K, Keskimäki I, Reunanen A et al. Equity in the use of antithrombotic drugs, beta-blockers and statins among Finnish coronary patients. Int J Equity Health 2008; 7: 16-20.
Go to original source...
Go to PubMed...
- Pretnar-Oblak J, Sebestjen M, Sabovic M. Statin treatment improves cerebral more than systemic endothelial dysfunction in patients with arterial hypertension. Am J Hypertens 2008; 21: 674-678.
Go to original source...
Go to PubMed...
- Foody JM, Joyce AT, Rudolph AE et al. Persistence of atorvastatin and simvastatin among patients with and without prior cardiovascular diseases: a US managed care study. Curr Med Res Opin 2008; 24: 1987-2000.
Go to original source...
Go to PubMed...
- Pella D. Statínová myopatia - rarita, alebo realita? Vnitř Lék 2010; 9: 972-976.
- Pregelj P. Involvement of cholesterol in the pathogenesis of Alzheimer's disease: Role of statins. Psychiatr Danub 2008; 20: 162-167.
Go to PubMed...
- Duron E, Hanon O. Vascular risk factors, cognitive decline and dementia. Vasc Health Risk Manag 2008; 4: 363-381.
Go to original source...
Go to PubMed...
- Kevelaitiene S, Slapikas R. A new approach to the treatment of dyslipidemia. Medicina (Kaunas) 2008; 44: 407-413.
Go to original source...
Go to PubMed...
- Goldstein MR, Mascitelli L, Pezzeta F. The double-edged sword of statin immunomodulation. Int J Cardiol 2008; 5: 432-436.
- Hirooka Y, Kimura Y, Sagara Y et al. Effects of valsartan or amlodipine on endothelial function and oxidative stress after one year follow-up in patients with essential hypertension. Clin Exp Hypertens 2008; 30: 267-276.
Go to original source...
Go to PubMed...
- Kudoh T, Nagawaga T, Nawaga I. Additional small amounts of diuretics improve blood pressure control at low cost without disadvantages in blood sugar metabolism. Hypertens Res 2008; 31: 455-462.
Go to original source...
Go to PubMed...
- Špinar J, Souček M. Přehodnocení doporučení pro diagnostiku a léčbu hypertenze. Vnitř Lék 2010; 56: 157-161.
Go to PubMed...