Literature review of the polypharmacy problem in older patients with cardiovascular diseases

Šarūnė Stankevičienė1

1Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Department of Cardiology, Kaunas, Lithuania


Introduction. with increasing quality of life, better disease prevention and treatment, people aged > 75 years represent the fastest growing population group in Western countries. These changes mean that increasing numbers of older people with ≥2 chronic conditions require polypharmacy. Aging leads to changes in the structure and function of the organs of the cardiovascular system, increasing the risk for cardiovascular disease (CAD) with age.

Aim. to review age-related changes in the cardiovascular system, pharmacodynamics and pharmacokinetics, and their implications for medical treatment in elderly patients with cardiovascular disease.

Methodology. A search in the “PubMed” database of articles published from 2016 to 2021 was accomplished. A review was performed using the following search keywords: polypharmacy, elderly patients, pharmacokinetics, pharmacodynamics, and cardiovascular disease. A review and analysis of 21 publications were performed.

Results. Age-related changes in the body, alterations in pharmacodynamics and pharmacokinetics may alter drug exposure and response in elderly patients compared with younger patients. In addition, polypharmacy increases the risk of adverse drug reactions and drug-drug interactions, which in turn may lead to higher mortality and healthcare costs. Unfortunately, there is limited evidence on the efficacy and safety of medications in older people with multimorbidity and polypharmacy.

Conclusion. The question of appropriate, safe, and effective pharmacotherapy in the elderly remains one of the greatest challenges in geriatric medicine. As the elderly population increases, more detailed and informed clinical studies and guidelines are needed.

Keywords: polypharmacy, elderly patients, cardiovascular disease.

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