[Digoxin therapy in the aged under serum level control with special reference to hypertension]

Area of Science:

• Pharmacology
• Geriatrics
• Cardiology

Background:

• Hypertension is a common condition, particularly in older adults.
• Digoxin is a medication used to treat heart conditions like hypertension.
• Age and renal function can affect drug metabolism and clearance.

Purpose of the Study:

• To investigate digoxin serum concentrations and intoxication rates in elderly hypertensive patients compared to younger ones.
• To evaluate the impact of age on digoxin pharmacokinetics in hypertensive patients.
• To provide recommendations for digoxin or digitoxin use in older adults with hypertension.

Main Methods:

• Serum digoxin concentrations were measured in 125 hypertensive patients aged over 65 years.
• These concentrations were compared to those in younger hypertensive patients.
• Creatinine and potassium levels were monitored to assess renal function.

Main Results:

• Elderly patients (over 65) exhibited significantly higher digoxin serum concentrations (2.36 +/- 1.19 nmol/l) compared to younger patients (1.45 +/- 0.55 nmol/l).
• Higher rates of digoxin intoxication were observed in the elderly group.
• Normal serum creatinine and potassium levels were noted in the elderly cohort, suggesting age-related factors beyond renal insufficiency contribute to higher digoxin levels.

Conclusions:

• Elderly hypertensive patients are at increased risk for digoxin toxicity due to higher serum concentrations.
• Digitoxin is recommended as a safer alternative to digoxin for patients around 65 years and older, or those with renal insufficiency.
• A mean maintenance dose of 0.1 mg/day of digitoxin should be considered for this patient population.