[Cardiovascular drugs in aged and multimorbid patients]

Praxis (Bern 1994). 2015 Sep 16;104(19):997-1000; quiz 1001-2. doi: 10.1024/1661-8157/a002139.
[Article in German]

Abstract

Cardiovascular diseases, such as arterial hypertension, heart failure, coronary artery disease, peripheral circulatory problems and atrial fibrillation are increasingly present in aged patients. Comorbidities, mainly diabetes, renal dysfunction, chronic bronchitis and degenerative joint diseases, are also frequent and need additional drug treatment. The usual polypharmacy often causes side effects due to overdosage and/or drug interactions. The main difficulty in choosing the proper therapeutic regimen consists in the lack of suitable dosing guidelines with adapted therapeutic targets for the older multimorbid population, usually not represented in the large controlled trials forming the basis of general recommendations. European guidelines for hypertension and heart failure are discussed as examples.

Keywords: Dosisempfehlungen in kardiovaskulären Richtlinien; Drug dosage in cardiovascular guidelines; Multimorbidität; Therapieziele im Alter; multimorbidity; therapeutic targets in aged patients.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Agents / adverse effects*
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / epidemiology
  • Combined Modality Therapy
  • Comorbidity
  • Dose-Response Relationship, Drug
  • Drug Interactions
  • Drug Therapy, Combination
  • Eplerenone
  • Female
  • Guideline Adherence
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy
  • Heart Failure / epidemiology
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy
  • Hypertension / epidemiology
  • Male
  • Mineralocorticoid Receptor Antagonists / adverse effects
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Pacemaker, Artificial
  • Risk Factors
  • Spironolactone / adverse effects
  • Spironolactone / analogs & derivatives
  • Spironolactone / therapeutic use

Substances

  • Cardiovascular Agents
  • Mineralocorticoid Receptor Antagonists
  • Spironolactone
  • Eplerenone