Archief Roodbont

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Summary and Comment

Statins were unlikely to be prescribed for patients 75 or older.

Previous research has shown that patients with known cardiovascular disease (CVD) are less likely to receive these drugs as they get older, and women are less likely than men to get these drugs. Whether the same is true for primary prevention of CVD is unclear. In this cross-sectional U.K. study, investigators assessed the effects of age and sex on primary prevention of CVD in 37,000 patients (age, 40).
The proportion of patients who received antihypertensive drugs increased with age from 5% among the youngest patients (age range, 40–44) to 57% among the oldest patients (age, 85). In fact, the likelihood of receiving an antihypertensive drug prescription increased significantly with each 5-year increment up to age 84 but not for age 85. The proportion of patients who received statins increased with age from 3% among the youngest patients (age range, 40–44) to 29% among patients who were 70 to 74. The likelihood of receiving a statin drug prescription increased significantly with each 5-year increment up to age 74 but decreased significantly with each 5-year increment thereafter. Treatment of women and men did not differ.
Comment: Increasing age increases risk for CVD, and many elders have high 10-year risk for CVD (20%). For some elders (age, 75), primary prevention with antihypertensive and statin drugs can lower this risk. However, fewer randomized trial data exist for this age group (and especially for age 85) than for age <75 75.="75." and="and" be="be" call="call" clarification="clarification" clinical="clinical" considered="considered" drugs="drugs" effects="effects" elders="elders" especially="especially" expectancy="expectancy" for="for" guidelines="guidelines" in="in" life="life" of="of" older="older" overall="overall" p="p" polypharmacy="polypharmacy" populations.="populations." researchers="researchers" should="should" than="than" the="the" these="these" those="those" trials="trials" using="using"> — Paul S. Mueller, MD, MPH, FACP
Published in Journal Watch General Medicine August 14, 2012

Citation(s):

Sheppard JP et al. Impact of age and sex on primary preventive treatment for cardiovascular disease in the West Midlands, UK: Cross sectional study. BMJ 2012 Jul 12; 345:e4535. (http://dx.doi.org/10.1136/bmj.e4535)

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