Wiener klinische Wochenschrift

, Volume 125, Issue 15–16, pp 425–436

Benefits and pitfalls of cardiovascular medication in seniors

  • Hana Matejovska Kubesova
  • Pavel Weber
  • Hana Meluzinova
  • Katarina Bielakova
  • Jan Matejovsky
review

Summary

Authors analyze actual situation in treatment of cardiovascular diseases in older patients. Different groups of recommended drugs are discussed separately; possible risks for elderly patients are stressed. Angiotensin converting enzyme inhibitors—this group is widely used in older patients because of their hypotensive effect, positive influence on cardiac failure, and positive modulation of endothelial dysfunction. The risk of hyperkalemia must be considered. Antiaggregants and anticoagulants are proved as potent prophylactic treatment, but the associated risk of gastrointestinal bleeding must be weighed very carefully. Bradycardia related to β-blockers, especially in combination with other medications lowering the heart rate must be taken into account. Otherwise, this group brings the highest profit in cardiovascular diseases as for morbidity and mortality. Attention is paid to calcium channel blockers, statins, diuretics, nitrates, and digoxin. A table listing the possible side effects and clinical symptoms of overdose by medications most frequently used in the elderly concludes the article.

Keywords

Angiotensin converting enzyme inhibitors Antiaggregants β-blockers Statins Calcium blockers Diuretics Digoxin Pharmacotherapy in the elderly Unwanted side effects Medical interactions 

Vorteile und Fallen der kardiovaskulären medikamentösen Therapie bei Senioren

Zusammenfassung

Die Autoren analysieren die aktuelle Situation der Therapie von kardiovaskulären Erkrankungen bei älteren Patienten. Verschiedene Gruppen der empfohlenen Medikamente werden unter besonderer Berücksichtigung möglicher Risiken bei älteren Patienten getrennt besprochen:

Die Gruppe der ACE-Hemmer wird bei älteren Patienten wegen ihres blutdrucksenkenden Effekts, sowie der günstigen Beeinflussung des kardialen Dekompensation und ihrer positiven Modulation der endothelialen Dysfunktion häufig verwendet. Das Risiko einer Hyperkaliämie muss berücksichtigt werden.

Thrombozytenaggregationshemmer und antikoagula­torische Substanzen sind in der Prophylaxe bewährte Substanzen. Allerdings muss das damit verbundene Risiko gastrointestinaler Blutungen genau abgewogen werden.

Eine β-Blocker induzierte Bradycardie – vor allem in Kombination mit anderen bradycardisierenden Substanzen – muss berücksichtigt werden, wobei besonders darauf hingewiesen wird, dass β-Blocker bei kardiovaskulären Erkrankungen den höchsten Vorteil in Bezug auf Mortalität und Morbidität bringen.

Die Aufmerksamkeit des Lesers wird auch noch auf Kalziumkanalblocker, Statine, Diuretika, Nitrate und Digoxin gelenkt.

Mit einer Tabelle, die die möglichen, bei älteren Patienten am häufigsten vorkommenden, Nebenwirkungen und klinischen Symptome einer Überdosierung aufzählt, schließt der Artikel.

Schlüsselwörter

Angiotensin-converting-enzyme (ACE) – hemmer Aggregationshemmer β-blocker Statine Kalziumkanalblocker Diuretika Digoxin Pharmakotherapie bei alten Menschen Nebenwirkungen Medizinische Interventionen 

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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Hana Matejovska Kubesova
    • 1
  • Pavel Weber
    • 1
  • Hana Meluzinova
    • 1
  • Katarina Bielakova
    • 1
  • Jan Matejovsky
    • 1
  1. 1.Department of Internal Medicine, Geriatrics and Practical MedicineMasaryk University Faculty of Medicine and Brno Faculty HospitalBrnoCzech Republic

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