Use of cardiovascular drugs by home-dwelling coronary patients aged 75 years and older

Abstract.

Objective: Elderly individuals constitute an increasing proportion of coronary patients, and up-to-date information is needed of their treatments in the community. Methods: A random sample of 75-, 80-, 85-, 90- and 95-year-old residents (n=3921) of Helsinki, Finland, was studied during 1998–1999. They were sent a postal questionnaire with questions about health, diseases and current drug use. Results: The response rate of home-dwelling elderly persons was 78% (n=2511). Of men and women, 75.8% and 79.8%, respectively, had some regular medication (P<0.05 between genders). Of home-dwelling individuals with coronary heart disease (CHD, n=717, 28.6%), 61.0% of women and 68.3% of men used aspirin, 58.4% and 52.9% nitrates, 54.7% and 52.4% beta-blockers, 20.0% and 13.7% (angiontensin-converting enzyme) ACE inhibitors and 25.1% and 21.1% calcium-channel blockers. Only 14.3% and 19.4% were on cholesterol-lowering drugs. The difference in ACE inhibitor, diuretic and digoxin use was statistically significant (P<0.05) between genders (women used more). Conclusion: Cardiovascular drug use is very common among the oldest age cohorts, but assuming that knowledge from younger individuals applies, there is a suboptimal use of several evidence-based treatments, especially lipid-lowering drugs, aspirin and beta-blockers in elderly coronary patients.