Abstract
Elderly patients constitute a group in whom diseases are “creeping up.” These diseases may not be cardiovascular but influence the general level of activity of the patient and the general feeling of health or ill-health. Therefore, the patient may apparently present with a cardiovascular problem when the real diagnosis lies elsewhere.
Unique features of illness in the elderly may interfere with effective drug therapy more than changed pharmacokinetics.
OUSLANDER, 1981 [1]
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Ouslander JG. Drug therapy in the elderly. Ann Intern Med 95:711–722, 1981.
Amery A, Brixko P, Clement D, et al. Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly Trial. Lancet 1:1349–1354, 1985.
Dall JLC. Maintenance digoxin in elderly patients. Br Med J 2:705–706, 1070.
Causack, B, Kelly J, O’Malley K, et al. Digoxin in the elderly: Pharmacokinetic consequences of old age. Clin Pharmacol Ther 25(6):772–776, 1979.
Ewy GA, Kapadia GG, and Yao L. Digoxin metabolism in the elderly. Circulation 39:449–453, 1969.
Berman W Jr and Musselman J. The relationship of age to the metabolism and protein binding of digoxin in sheep. J Pharmacol Exp Ther 208(2):263–266, 1979.
Gerstenblith G, Spurgeon HA, Froehlich JP, et al. Diminished inotropic responsiveness to ouabain in aged rat myocardium. Circ Res 44(4):517–523, 1979.
Guarnieri T, Spurgeon H, Froehlich JP, et al. Diminished inotropic responses but unaltered toxicity to acetylsbrophanthidin in the senescent beagle. Circulation 60(7):1548–1554, 1979.
Whiting B, Wandless I, Summer DJ, and Goldberg A. Computer-assisted review of digoxin therapy in the elderly. Br Heart J 40(1):8–13, 1978.
Castleden et al. Br J Clin Pharmacol 2:303, 1975.
Vestal RE, Wood AJ, and Shand DG. Reduced beta-adrenoceptor sensitivity in the elderly. Clin Phar Ther 26(2):181–186, 1979.
Schocken DD and Roth GS. Reduced beta-adrenergic receptor concentrations in ageing man. Nature 267 (5614):856–858, 1977.
Yin FCP, Spurgeon HA, Raizes GS, et al. Age-associated decrease in chronotropic response to isoproterenol (abstract). Circulation 54 11:167, 1976.
Cokkinos DV, Tsartsalis GD, Heimonas ET, and Gardikas CD. Comparison of the inotropic action of digitalis and isoproterenol in younger and older individuals. Am Heart J 100(6 Pt 1):802–806, 1980.
Guarnieri T, Filburn CR, Zitnik G, et al. Contractile and biochemical correlates of beta-adrenergic stimulation of the aged heart. Am J Physiol 239(4):H501-H508, 1980.
Nation RI, Triggs EJ, and Selig M. Lignocaine kinetics in cardiac patients and aged subjects. Br J Clin Pharmacol 4(4):439–448, 1977.
Reidenberg MM, Camacho M, Kluger J, and Drayer DE. Aging and renal clearance of procainamide and acetylprocainamide. Clin Pharmacol Ther 28(6):732–735, 1980.
Ochs HR, Greenblatt DJ, Woo E, and Smith TW. Reduced quinidine clearance in eldery persons. Am J Cardiol 42(3):481–485, 1978.
Shepherd AM, Hewick DS, Moreland TA, and Stevenson IH. Age as a determinant of sensitivity to warfarin. Br J Clin Pharmacol 4:315–320, 1977.
Ashraf N, Locksley R, and Arieff AI. Thiazide-induced hyponatremia associated with death or neurologic damage in outpatients. Am J Med 70:1163–1168, 1981.
Epstein M and Hollenberg NK. Age as determinant of renal sodium conservation in normal man. J Lab Clin Med 87:411–417, 1976.
Zacharias FJ and Cruickshank JM. Treating the elderly hypertensive. Acta Therap 5:179–192, 1979.
Coope J, Warrender TS. Randomised trial of treatment of hypertension in elderly patients in primary care. Brit. Med. J. 293:1145–1148, 1986.
Bühler FR, Bolli P, Erne P, et al. Position of calcium antagonists in antihypertensive therapy. J Cardiovasc Pharmacol 7 (suppl 4): 521-S27, 1985.
Ben-Ishay D, Leibel B, and Stessman J. Calcium channel blockers in the management of hypertension in the elderly. Am J Med 81 (Suppl 6A):30–34, 1986.
Harris R. The old heart. In G Bourne (ed), Hearts and Heart-like Organs, Vol. 3. New York: Academic Press, 1980, pp 159–188.
Chaudhry AY, Bing RF, Castelden CM, et al. The effect of ageing on the response to frusemide in normal subjects. Eur J Clin Pharmacol 27:303–306, 1984.
Andreasen F, Hansen U, Husted SE, et al. The influence of age on renal and extrarenal effects of frusemide. Brit J Clin Pharmac 18:65–74, 1984.
Hamdy RC. Diuretic Therapy in the Older Patient. Philadelphia: Smith, Kline and French, 1978, pp 47–50.
Lye M. Body potassium content and capacity of elderly individuals with and without cardiac failure. Cardiovasc Res 16:22–25, 1982.
Gersh BJ, Kronmal RA, Schaff HV, et al. Long-term (5 year) results of coronary bypass surgery in patients 65 years old or older: A report from the Coronary Artery Surgery Study. Circulation 68 (Suppl II): 11–190–11–199, 1983.
Knapp WS, Douglas JS, Craver JM, et al. Efficacy of coronary bypass grafting in elderly patients with coronary artery disease. Am J Cardiol 47:923–930, 1981.
Wintzen AR, Tijssen JGP, deVries WA, et al. Risk of long-term oral anticoagulant therapy in elderly patients after myocardial infarction. Second report of the sixty plus reinfarction study research group. Lancet 1:64–68, 1982.
Hawkins CM, Richardson DW, Vokonas PS. Effect of propranolol in reducing mortality in older myocardial infarction patients. The Beta-Blocker Heart Attack Trial experience. Circulation 67 (Suppl I):I-94-I97, 1983.
Gundersen, T. Abrahamsen AM, Kjekshus J, and Ronnevik PK. Timolol-related reduction in mortality and reinfarction in patients aged 65–75 years surviving acute myocardial infarction. Circulation 66:1179–1184, 1982.
Olsson G, Rehnqvist N, Sjogren A, et al. Long-term treatment with metoprolol after myocardial infarction: Effect on 3 year mortality and morbidity. J Am Coll Cardiol 5:1428–1437, 1985.
Schocken DD, Blumenthal JA, Port S. et al. Physical conditioning and left ventricular performance in the elderly: Assessment by radionuclide angiocardiography. Am J Cardiol 52:359–364, 1983.
The Anturane Reinfarction Trial Research Group. Sulfinpyrazone in the prevention of sudden death after myocardial infarction. N Engl J Med 302(5):250–256, 1980.
Anturane Reinfarction Italian Study. Sulphinpyrazone in postmyocardial infarction. Lancet 1:237–242, 1982.
Aspirin Myocardial Infarction Study Research Group. A randomized controlled trial of aspirin in persons recovered from myocardial infarction. JAMA 243:661–669, 1980.
Persantine-Aspirin Reinfarction Study Research Group. Persantine and aspirin in coronary heart disease. Circulation 62:449–461, 1980.
Murphy ES, Lawson RM, Starr A, et al. Severe aortic stenosis in patients 60 yeras of age and older: left ventricular function and 10-year survival after valve replacement. Circulation 64 (Suppl II):II-184–II–188, 1981.
Commerfold PJ, Curcio A, Albanese M, and Beck W. Aortic valve replacement in the elderly. South Afr Med J 59:975–976, 1981.
De Bono AHB, English TAH, and Milstein BB. Heart valve replacement in the elderly. Br Med J 2:917–919, 1978.
Waller BF and Roberts WC. Cardiovascular disease in the very elderly. Analysis of 40 necropsy patients aged 90 years or over. Am J Cardiol 51:403–421, 1983.
Kolibash AJ, Bush CA, Fotana MB, et al. Mitral valve prolapse syndrome: Analysis of 62 patients aged 60 years and older. Am J Cardiol 52:534–539, 1983.
Templeton GH, Platt MR, Willerson JT, and Weisfeldt MI. Influence of aging on left ventricular hemodynamics and stiffness in beagles. Circ Res 44:189–194, 1979.
Camm AJ, Evans KE, Ward DE, and Martin A. The rhythm of the heart in active elderly subjects. Am Heart J 99:598–603, 1980.
Canadian Cooperative Study Group. A randomized trial of aspirin and sulfinpyrazone in threatened stroke. N Engl J Med 229:53–59, 1978.
Fields WS, Lemak NA, Frankowski KF, et al. Controlled trial of aspirin in cerebral Uchemia. Circulation 62 (Suppl V):V90—V96, 1980.
Suggested Readings
Anderson GJ. Clinical clues to digitalis toxicity. Geriatrics 35(6):57–65, 1980.
Harris R. The Management of Geriatric Cardiovascular Disease. Philadelphia: Lippincott, 1970.
Lee PV. Drug therapy in the elderly: The clinically pharmacology of aging. Clin Exper Res 2:39–42.
Lowenthal DT and Affrime MB. Cardiovascular drugs for the geriatric patient. Cardiology 36:65–74, 1981.
Mitenko PA, Comfort A, and Crooks J (eds). Drugs and the elderly. Proceedings of a symposium. J Chronic Dis 36(1), 1983.
O’Hanrahan M and O’Malley K. Compliance with drug treatment. Br Med J 283:298–300, 1981.
Swift CG. Clinical pharmacology in the elderly. Scott Med J 24:221–225, 1979.
Unverferth DV, Magorien RD, and Leier CV. Drug regimens for congestive heart failure. Geriatrics 35(7):26–33, 1980.
Vestal RE. Drug use in the elderly: A review of problems and special considerations. Drugs 16:358–382, 1978.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1987 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Opie, L.H., Mabin, T.A. (1987). Medical Treatment of Cardiovascular Disease in the Elderly. In: Messerli, F.H. (eds) Cardiovascular Disease in the Elderly. Developments in Cardiovascular Medicine, vol 76. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-9925-4_18
Download citation
DOI: https://doi.org/10.1007/978-1-4684-9925-4_18
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4684-9927-8
Online ISBN: 978-1-4684-9925-4
eBook Packages: Springer Book Archive