Use of cardiovascular drugs in an older Swedish population.
OBJECTIVE
To describe the use of cardiovascular drugs in an older population with respect to age, sex, housing type, and creatinine clearance.


METHODS
A cross-sectional survey.


METHODS
All residents of a district of Stockholm (Kungsholmen), Sweden, aged 75 and older, living in institutions or at home.


METHODS
Cardiovascular drug use, serum creatinine, electrolytes, height, weight, and symptoms.


RESULTS
A total of 43 cardiovascular (CV) drugs were used. The most common drugs were digoxin (used by 18.2%), furosemide (16.4%), and glyceryl trinitrate (12.4%). Drugs with an antihypertensive effect accounted for 61% of all CV drugs. CV drug use increased with age for cardiac glycosides and diuretics, but decreased with age for calcium antagonists and beta-blockers. Drug doses tended to be less than the recommended daily dose except for a few drugs, e.g., furosemide. There was a trend toward decreasing dose with increasing age, but this was not significant. Diuretics were the only CV drugs used more often in women. People living in institutional care used the least amount of CV drugs. The dose of drugs taken did not appear to be related to estimated creatinine clearance. Comparisons between drug use and complaint of symptoms showed a strong correlation between the use of cardiac glycosides and anorexia, calcium antagonists and constipation, and nitrates and vertigo. There were weaker correlations with cardiac glycosides and visual disturbances and with potassium sparing diuretics and a high potassium.


CONCLUSIONS
CV drugs are used commonly in older people. We suggest that the symptoms correlating with cardiac glycoside use may be signs of unrecognized toxicity, and this may relate to our finding that drug use is often not tailored to renal function as measured by creatinine clearance.
Wills
P
P
Stockholm Gerontology Research Centre, Sweden.
Fastbom
J
J
Claesson
C B
CB
Cornelius
C
C
Thorslund
M
M
Winblad
B
B
D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D017678:Sex Distribution; D013548:Sweden
D002317:Cardiovascular Agents; D003404:Creatinine