BACKGROUND: Several drugs, including β-blockers (β-adrenoceptor antagonists), are largely under-utilized in older patients with cardiovascular disease. OBJECTIVES: The aims of this study were to evaluate whether older patients (aged ≥65 years) with coronary artery disease (CAD) have a different pattern of use of β-blockers than younger adult patients (aged <65 years) and whether gender differences or other clinical variables may influence the use of these drugs. METHODS: Over 6 months, 2226 outpatients with stable CAD were enrolled in an observational, cross-sectional, multicentre survey. Of these, 1416 patients aged ≥65 years were grouped into four subgroups according to age. Predictors of β-blocker use were determined using logistic regression analyses. Comparisons between younger adults and older patients were conducted using Student's t-tests and chi-squared (χ2) tests. RESULTS: Up to 47% of older patients were not receiving β-blockers, and this percentage progressively increased with age, with the oldest patients showing the lowest rate of utilization. No gender difference in the pattern of use of β-blockers was noted. The prescription of β-blockers was higher in patients with heart failure (HF) than in patients without HF. The presence of HF abolished the decrease in β-blocker use with age. Logistic regression analysis confirmed that lower age and severe HF were independent predictors of β-blocker use in older people. CONCLUSIONS: Age appears to be a key factor in the under-prescription of β-blockers in CAD outpatients. Despite the recommendations, and the efforts of cardiologists, the use of β-blockers in the elderly is still limited, possibly because of practical constraints such as adverse effects and co-morbidity. In patients with HF, age is less important in determining the use of β-blockers.
BACKGROUND: Several drugs, including β-blockers (β-adrenoceptor antagonists), are largely under-utilized in older patients with cardiovascular disease. OBJECTIVES: The aims of this study were to evaluate whether older patients (aged ≥65 years) with coronary artery disease (CAD) have a different pattern of use of β-blockers than younger adult patients (aged <65 years) and whether gender differences or other clinical variables may influence the use of these drugs. METHODS: Over 6 months, 2226 outpatients with stable CAD were enrolled in an observational, cross-sectional, multicentre survey. Of these, 1416 patients aged ≥65 years were grouped into four subgroups according to age. Predictors of β-blocker use were determined using logistic regression analyses. Comparisons between younger adults and older patients were conducted using Student's t-tests and chi-squared (χ2) tests. RESULTS: Up to 47% of older patients were not receiving β-blockers, and this percentage progressively increased with age, with the oldest patients showing the lowest rate of utilization. No gender difference in the pattern of use of β-blockers was noted. The prescription of β-blockers was higher in patients with heart failure (HF) than in patients without HF. The presence of HF abolished the decrease in β-blocker use with age. Logistic regression analysis confirmed that lower age and severe HF were independent predictors of β-blocker use in older people. CONCLUSIONS: Age appears to be a key factor in the under-prescription of β-blockers in CAD outpatients. Despite the recommendations, and the efforts of cardiologists, the use of β-blockers in the elderly is still limited, possibly because of practical constraints such as adverse effects and co-morbidity. In patients with HF, age is less important in determining the use of β-blockers.
Authors: Nigel J Dudley; Ann Bowling; Matthew Bond; Dorothy McKee; Marie McClay Scott; Adrian Banning; Andrew T Elder; A Tony Martin; Iva Blackman Journal: Age Ageing Date: 2002-01 Impact factor: 10.668
Authors: François Schiele; Nicolas Meneveau; Marie France Seronde; Vincent Descotes-Genon; Joanna Oettinger; Fiona Ecarnot; Jean-Pierre Bassand Journal: Eur Heart J Date: 2009-01-27 Impact factor: 29.983
Authors: Kenneth Dickstein; Alain Cohen-Solal; Gerasimos Filippatos; John J V McMurray; Piotr Ponikowski; Philip Alexander Poole-Wilson; Anna Strömberg; Dirk J van Veldhuisen; Dan Atar; Arno W Hoes; Andre Keren; Alexandre Mebazaa; Markku Nieminen; Silvia Giuliana Priori; Karl Swedberg Journal: Eur Heart J Date: 2008-09-17 Impact factor: 29.983
Authors: Michel Komajda; Olivier Hanon; Matthias Hochadel; Jose Luis Lopez-Sendon; Ferenc Follath; Piotr Ponikowski; Veli-Pekka Harjola; Helmut Drexler; Kenneth Dickstein; Luigi Tavazzi; Markku Nieminen Journal: Eur Heart J Date: 2008-12-23 Impact factor: 29.983