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Influence of hospitalisation on the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in elderly hypertensive patients

Aging Clinical and Experimental Research volume 26, pages 307–314 (2014)Cite this article

Abstract

Background and aims

The underutilization of beneficial cardiovascular medications such as angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) in the elderly patients continues to be a matter of concern. The aim of the presented study was to compare the prescription of ACEI and ARB in elderly hypertensive patients at the time of hospital admission and discharge and to identify patient-related factors which determine the prescription of ACEI/ARB.

Methods

The study sample (n = 1111) was selected from 2,157 patients hospitalised at long-term care departments of three municipal hospitals during the period between January 1, 2008 and December 31, 2009 and included hypertensive patients aged ≥65 years suffering from myocardial infarction, heart failure, atrial fibrillation, diabetes mellitus or nephropathy.

Results

In hypertensive patients with myocardial infarction, diabetes mellitus and nephropathy, a significant increase was found in the use of ACEI/ARB during hospitalisation. However, there was no similar change in the use of such medications during hospitalisation in patients with heart failure and atrial fibrillation. Age ≥85 years (OR = 0.59 and OR = 0.50 at hospital admission and discharge, respectively), depression (OR = 0.63 at hospital discharge) and the systolic blood pressure ≤115 mmHg (OR = 0.45 at hospital discharge) decreased the probability of ACEI/ARB prescription. On the other hand, increasing the number of evaluated co-morbid conditions increased the patient’s likelihood of being an “ACEI/ARB user” (OR = 1.20 at hospital discharge).

Conclusions

Our study has identified a subset of elderly hypertensive patients (with heart failure, atrial fibrillation) in whom the use of ACEI/ARB could be improved.

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Acknowledgments

This study was supported by grant VEGA 1/0886/14. The grant providers played no role in the design, methods, data collection, analysis and interpretation of the data, preparation of the paper or in the decision to submit the manuscript. We thank Dr. Agata Argalasova, Dr. Silvia Cervenova and Daniel Klinovsky for their assistance with data collection.

Conflict of interest

None.

Author information

Affiliations

  1. Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Sasinkova, 4, 811 08, Bratislava, Slovakia

    Martin Wawruch & Veronika Slezakova

  2. 1st Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia

    Jan Murin

  3. Department of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Bratislava, Slovakia

    Jan Luha

  4. Department of Trauma Surgery, University Hospital Bratislava, Bratislava, Slovakia

    Michal Bozik

  5. Department of Geriatrics, Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia

    Tatiana Leitmann

  6. Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia

    Magdalena Kuzelova

  7. Gerrards Cross, Bucks, UK

    Rashmi Shah

Authors
  1. Martin Wawruch
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  2. Veronika Slezakova
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  3. Jan Murin
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  4. Jan Luha
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  5. Michal Bozik
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  6. Tatiana Leitmann
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  7. Magdalena Kuzelova
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  8. Rashmi Shah
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Correspondence to Martin Wawruch.

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Wawruch, M., Slezakova, V., Murin, J. et al. Influence of hospitalisation on the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in elderly hypertensive patients. Aging Clin Exp Res 26, 307–314 (2014). https://doi.org/10.1007/s40520-014-0231-1

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  • DOI: https://doi.org/10.1007/s40520-014-0231-1

Keywords

  • Elderly
  • Hypertension
  • Co-morbidity
  • Atrial fibrillation
  • Diabetes mellitus
  • Heart failure