Author: Mangoni, Arduino A.

Source: Drugs & Aging, Volume 22, Number 11, 2005 , pp. 913-941(29)

Publisher: Adis International

Abstract:

An increasing number of elderly patients are exposed to cardiovascular drugs for the treatment of acute and/or chronic conditions. This is a result of the progressive aging of the population, a common feature in most industrialised countries, and an improvement in primary and secondary cardiovascular prevention strategies with increased survival rates. Traditionally, most elderly patients receiving cardiovascular drugs had advanced cardiac, liver and kidney disease that significantly influenced drug pharmacokinetic and pharmacodynamic parameters. Currently, however, many patients without significant organ impairment receive cardiovascular therapy for primary or early secondary prevention (i.e. increased vascular risk, asymptomatic left ventricular dysfunction, poststroke phase, type 2 diabetes mellitus), highlighting the need for a better understanding of specific age-related pharmacokinetic and pharmacodynamic effects.

A systematic review has been conducted on the specific effects of aging, in the absence of major co-morbidities, on the pharmacokinetic and pharmacodynamic properties of traditional and newer cardiovascular drugs. Currently, the evidence available is poor or nonexisting for several drugs and mainly derived from very small and underpowered studies, thus limiting data interpretation. In particular, there is very little information on patients >80 years of age, thus raising important concerns about the correct use of these drugs in this constantly growing population.

Keywords: ACE inhibitors; Angiotensin II 1 receptor antagonists; Antiarrhythmics; Anticoagulants; Antiplatelets; Beta adrenoceptor antagonists; Calcium channel antagonists; Cardiovascular disorders; Cardiovascular therapies; Elderly; HMG CoA reductase inhibitors; Thrombolytics

Document Type: Review article

Affiliations: 1: Department of Clinical Pharmacology, School of Medicine, Flinders University, Adelaide, South Australia, Australia

Publication date: 2005-01-01

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