Medical Treatment of Cardiovascular Disease in the Elderly

  • Lionel H. Opie
  • T. A. Mabin
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 31)


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.


Mitral Valve Aortic Stenosis Infective Endocarditis Systolic Hypertension Mitral Valve Replacement 
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  1. 1.
    Ouslander JG. Drug therapy in the elderly. Ann Intern Med 95: 711–722, 1981.PubMedGoogle Scholar
  2. 2.
    Dall JLC. Maintenance digoxin in elderly patients. Br Med J 2: 705–706, 1970.PubMedCrossRefGoogle Scholar
  3. 3.
    Cusack B, Kelly J, O’Malley K, Noel J, Lavan J, and Horgan J. Digoxin in the elderly: Pharmacokinetic consequences of old age. Clin Pharmacol Ther 25 (6): 772–776, 1979.PubMedGoogle Scholar
  4. 4.
    Ewy GA, Kapadia GG, and Yao L. Digoxin metabolism in the elderly. Circulation 39: 449453, 1969.Google Scholar
  5. 5.
    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.PubMedGoogle Scholar
  6. 6.
    Gerstenblith G, Spurgeon HA, Froehlich JP, Weisfeldt ML, and Lakatta EG. Diminished inotropic responsiveness to ouabain in aged rat myocardium. Circ Res 44 (4): 517–523, 1979.PubMedCrossRefGoogle Scholar
  7. 7.
    Guarnieri T, Spurgeon H, Froehlich JP, Weisfeldt ML, and Lakatta EG. Diminished inotropic responses but unaltered toxicity to acetylsbrophanthidin in the senescent beagle. Circulation 60 (7): 1548–1554, 1979.PubMedCrossRefGoogle Scholar
  8. 8.
    Whiting B, Wandless I, Sumner DJ, and Goldberg A. Computer-assisted review of digoxin therapy in the elderly. Br Heart J 40 (1): 8–13, 1978.PubMedCrossRefGoogle Scholar
  9. 9.
    Castleden et al. Br J Clin Pharmacol 2: 303, 1975.PubMedCrossRefGoogle Scholar
  10. 10.
    Vestal RE, Wood AJ, and Shand DG. Reduced beta-adrenoceptor sensitivity in the elderly. Clin Phar Ther 26 (2): 181–186, 1979.Google Scholar
  11. 11.
    Schocken DD and Roth GS. Reduced beta-adrenergic receptor concentrations in ageing man. Nature 267 (5614): 856–858, 1977.PubMedCrossRefGoogle Scholar
  12. 12.
    Yin FCP, Spurgeon HA, Raizes GS, Greene HL, Weisfeldt ML, and Shock NW. Age-associated decrease in chronotropic response to isoproterenol (abstract). Circulation 5411: 167, 1976.Google Scholar
  13. 13.
    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.PubMedCrossRefGoogle Scholar
  14. 14.
    Guarnieri T, Filburn CR, Zitnik G, Roth GS, and Lakatta EG. Contractile and biochemical correlates of beta-adrenergic stimulation of the aged heart. Am J Physiol 239(4):HSO1–HSO8, 1980.Google Scholar
  15. 15.
    Nation RI, Triggs EJ, and Selig M. Lignocaine kinetics in cardiac patients and aged subjects. Br J Clin Pharmacol 4 (4): 439–448, 1977.PubMedCrossRefGoogle Scholar
  16. 16.
    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.PubMedCrossRefGoogle Scholar
  17. 17.
    Ochs HR, Greenblatt DJ, Woo E, and Smith TW. Reduced quinidine clearance in elderly persons. Am J Cardiol 42 (3): 481–485, 1978.PubMedCrossRefGoogle Scholar
  18. 18.
    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.PubMedCrossRefGoogle Scholar
  19. 19.
    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.PubMedCrossRefGoogle Scholar
  20. 20.
    Zacharias FJ, Cruickshank JM. Treating the elderly hypertensive. Acta Therapeutica 5: 179192, 1979.Google Scholar
  21. 21.
    Buhler FR, Burkort F, Lutold BE, Kung M, Marbet G, and Pfisterer M. Antihypertensive beta-blocking action as related to renin and age: A pharmacologic tool to identify pathogenetic mechanisms in essential hypertension. Am J Cardiol 36: 653–669, 1975.PubMedCrossRefGoogle Scholar
  22. 22.
    Harris R. The old heart. In G. Bourne (ed), Hearts and Heart-like Organs, vol. 3. New York: Academic Press, 1980, pp 159–188.Google Scholar
  23. 23.
    Hamdy RC. Diuretic Therapy in the Older Patient. Smith, Kline and French, 1978, pp 47–50.Google Scholar
  24. 24.
    Wintzen AR, Tijssen JGP, deVries WA, Loeliger EA, and Roos J. Risks 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.Google Scholar
  25. 25.
    The Beta-blocker Heart Attack Trial. Beta-Blocker Heart Attack Study Group. JAMA 246 (18): 2073–2074, 1981.CrossRefGoogle Scholar
  26. 26.
    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.CrossRefGoogle Scholar
  27. 27.
    Anturane Reinfarction Italian Study. Sulphinpyrazone in post-myocardial infarction. Lancet 1: 237–242, 1982.Google Scholar
  28. 28.
    Aspirin Myocardial Infarction Study Research Group. A randomized controlled trial of aspirin in persons recovered from myocardial infarction. JAMA 243: 661–669, 1980.CrossRefGoogle Scholar
  29. 29.
    Persantine-Aspirin Reinfarction Study Research Group. Persantine and aspirin in coronary heart disease. Circulation 62: 449–461, 1980.CrossRefGoogle Scholar
  30. 30.
    Commerford PJ, Curcio A, Albanese M, and Beck W. Aortic valve replacement in the elderly. South Afr Med J 59: 975–976, 1981.Google Scholar
  31. 31.
    de Bono AHB, English TAH, and Milstein BB. Heart valve replacement in the elderly. Br Med J 2: 917–919, 1978.PubMedCrossRefGoogle Scholar
  32. 32.
    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.PubMedCrossRefGoogle Scholar
  33. 33.
    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.PubMedCrossRefGoogle Scholar

Suggested Readings

  1. Anderson GJ. Clinical clues to digitalis toxicity. Geriatrics 35 (6): 57–65, 1980.PubMedGoogle Scholar
  2. Harris R. The Management of Geriatric Cardiovascular Disease. Philadelphia: Lippincott, 1970.Google Scholar
  3. Lee PV. Drug therapy in the elderly: The clinically pharmacology of aging. Clin Exper Res 2:3942Google Scholar
  4. Lowenthal DT and Affrime MB. Cardiovascular drugs for the geriatric patient. Cardiology 36: 65–74, 1981.Google Scholar
  5. Mitenko PA, Comfort A, and Crooks J (eds). Drugs and the elderly. Proceedings of a symposium. J Chronic Dis 36(1), 1983.Google Scholar
  6. O’Hanrahan M and O’Malley K. Compliance with drug treatment. Br Med J 283: 298–300, 1981.CrossRefGoogle Scholar
  7. Swift CG. Clinical pharmacology in the elderly. Scott Med.] 24: 221–225, 1979.Google Scholar
  8. Unverferth DV, Magorien RD, and Leier CV. Drug regimens for congestive heart failure. Geriatrics 35 (7): 26–33, 1980.PubMedGoogle Scholar
  9. Vestal RE. Drug use in the elderly: A review of problems and special considerations. Drugs 16: 358–382, 1978.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1984

Authors and Affiliations

  • Lionel H. Opie
  • T. A. Mabin

There are no affiliations available

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