Related Experiment Videos
[Treatment of elderly patients with hypertension--complications and current drug therapy]
Y Takagawa1, K Shimamoto, A Masuda
1Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Japan.
Insights
Calcium antagonists are the most common drug for elderly hypertension patients. Prescription patterns vary by age and specific health complications, indicating tailored therapeutic approaches.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacology
Background:
- Hypertension management in the elderly is complex.
- Understanding current prescribing trends is crucial for optimizing patient care.
Purpose of the Study:
- To investigate contemporary drug therapy for elderly hypertensive patients.
- To analyze age-dependent and complication-specific prescription patterns.
Main Methods:
- A case-card study was conducted at Sapporo Medical University and its affiliated hospitals.
- Data from 2897 valid cases included hypertension drug prescriptions, complications, and blood pressure.
- Patients were categorized into elderly (>= 65 years) and non-elderly groups.
Main Results:
- Calcium antagonists were the most frequently prescribed drug (76.3%) across all age groups.
- Elderly patients received more diuretics, while younger patients were more often prescribed beta-blockers and ACE inhibitors.
- Specific drug choices varied with comorbidities like ischemic heart disease, renal dysfunction, diabetes mellitus, and stroke.
Conclusions:
- Calcium antagonists are a cornerstone in treating hypertension, regardless of patient age.
- Age-related pathophysiological differences influence the selection of other antihypertensive medications.
- Comorbidities necessitate tailored drug selection for effective hypertension management.
Abstract:
To investigate current drug therapy for elderly hypertensive patients, we performed a case-card study at Sapporo Medical University and its branch hospitals. The case-card was designed to show prescriptions given for hypertension, complications, and blood pressure. In the 2897 valid cases, calcium antagonists were prescribed in 76.3%, followed by beta-blockers (31.4%), angiotensin-converting enzyme inhibitors (ACE-I) (25.1%) and natriuretic diuretics (18.1%). When the patients were divided into an elderly group (> or = 65 y.o., n = 1475), beta-blockers and ACE-I were found to be more frequently used in the non-elderly group, and diuretics were more frequently prescribed in the elderly group. Calcium antagonists were the most frequently used drugs, irrespective of age. As monotherapy drugs, calcium antagonists were chosen most frequently in both groups. Diuretics were the second most frequently used drug in the elderly group, but beta-blockers occupied that position in the younger group and these patients as a whole. In the elderly group, the manner of prescription was analyzed according to major complications. In patients with ischemic heart disease, beta-blockers and diuretics were used more frequently than in patients without that condition. Diuretics were prescribed more frequently in patients with renal dysfunction. Calcium antagonists and ACE-I were used more frequently in the patients with diabetes mellitus. The same differences were found in the non-elderly patients with those complications. However, among patients with stroke, calcium antagonists were more frequently used in the elderly group and ACE-I were performed in the younger patients. In conclusion, calcium antagonists were used very often regardless of age, and the other drugs were used according to age-dependent differences in pathophysiologic mechanism.