AIMS: The effectiveness of multifactorial cardiovascular disease prevention in patients aged 75 years or older is uncertain, because these patients have often been excluded from trials. The aim of this pre-planned, first-year analysis of the Drugs and Evidence-Based Medicine in the Elderly (DEBATE) Study was to determine the feasibility of prevention efforts in elderly cardiovascular patients. METHODS AND RESULTS: For DEBATE, home-dwelling individuals aged 75 years and over with cardiovascular diseases (n=400, mean age 80 years, 65% women) were recruited from the community. These high-risk participants were randomly assigned to the intervention group (n=199) where both lifestyle modification and pharmacological cardiovascular treatments are individualized by a geriatrician according to current European guidelines. The control group (n=201) receives the usual care. Interim analysis of the study groups at one year shows that intervention has succeeded in increasing the use of statins, aspirin, beta-blockers, and ACE inhibitors, and decreasing serum cholesterol (p<0.0001), LDL-cholesterol (p<0.0001), and hsCRP (p=0.04). Body mass index, blood pressure, and blood glucose were similar at one year in both groups. No safety problems or adverse effects on health-related quality of life were observed and compliance was good. CONCLUSIONS: It is possible and safe to institute evidence-based cardiovascular treatments in the 75+ cardiovascular patients in a real life setting, but only serum cholesterol and hsCRP are significantly decreased.
RCT Entities:
AIMS: The effectiveness of multifactorial cardiovascular disease prevention in patients aged 75 years or older is uncertain, because these patients have often been excluded from trials. The aim of this pre-planned, first-year analysis of the Drugs and Evidence-Based Medicine in the Elderly (DEBATE) Study was to determine the feasibility of prevention efforts in elderly cardiovascular patients. METHODS AND RESULTS: For DEBATE, home-dwelling individuals aged 75 years and over with cardiovascular diseases (n=400, mean age 80 years, 65% women) were recruited from the community. These high-risk participants were randomly assigned to the intervention group (n=199) where both lifestyle modification and pharmacological cardiovascular treatments are individualized by a geriatrician according to current European guidelines. The control group (n=201) receives the usual care. Interim analysis of the study groups at one year shows that intervention has succeeded in increasing the use of statins, aspirin, beta-blockers, and ACE inhibitors, and decreasing serum cholesterol (p<0.0001), LDL-cholesterol (p<0.0001), and hsCRP (p=0.04). Body mass index, blood pressure, and blood glucose were similar at one year in both groups. No safety problems or adverse effects on health-related quality of life were observed and compliance was good. CONCLUSIONS: It is possible and safe to institute evidence-based cardiovascular treatments in the 75+ cardiovascular patients in a real life setting, but only serum cholesterol and hsCRP are significantly decreased.
Authors: Juho Uusvaara; Kaisu H Pitkala; Hannu Kautiainen; Reijo S Tilvis; Timo E Strandberg Journal: Drugs Aging Date: 2011-02-01 Impact factor: 3.923
Authors: David Edelman; Eugene Z Oddone; Richard S Liebowitz; William S Yancy; Maren K Olsen; Amy S Jeffreys; Samuel D Moon; Amy C Harris; Linda L Smith; Ruth E Quillian-Wolever; Tracy W Gaudet Journal: J Gen Intern Med Date: 2006-07 Impact factor: 5.128
Authors: Bernadeta Bridgwood; Kate E Lager; Amit K Mistri; Kamlesh Khunti; Andrew D Wilson; Priya Modi Journal: Cochrane Database Syst Rev Date: 2018-05-07
Authors: Elena Colicino; Danielle B Hazeltine; Kelly M Schneider; Anna Zilverstand; Keren Bachi; Nelly Alia-Klein; Rita Z Goldstein; Andy C Todd; Megan K Horton Journal: Environ Dis Date: 2019-09-27