The effect of selected patient's characteristics on the choice of antihypertensive medication in the elderly in Slovakia.
OBJECTIVE
The aim of the present study was to determine which patient-related characteristics influence the selection of the antihypertensive drug class in elderly patients in Slovakia.


METHODS
The sample for our study (n = 401) was selected from 1045 patients admitted to the Department of Internal Medicine of a general hospital during the period of 1 December 2003-31 March 2005. Patients aged 65 or more with documented arterial hypertension and treated with at least one antihypertensive drug were enrolled in our retrospective study. Specific socio-demographic and clinical characteristics as well as cardiovascular comorbid conditions were evaluated as potential factors that could have influenced the choice of antihypertensive drug class.


RESULTS
The most frequently prescribed antihypertensive drugs were angiotensin-converting enzyme (ACE) inhibitors and diuretics (61.8% and 60.1% of patients, respectively). Patients aged >/= 85 years had lower probability of ACE inhibitors prescription (OR = 0.49). Females had higher chance of calcium channel blockers use (OR = 3.84) and lower odds of diuretics administration (OR = 0.50). In patients living alone, ACE inhibitors were preferred (OR = 2.16). The use of diuretics was more frequent in polymorbid patients (OR = 1.95). Immobile patients had lower chance of being prescribed beta-blockers and calcium channel blockers (OR = 0.25 and OR = 0.39, respectively).


CONCLUSIONS
The present study revealed that the selection of the antihypertensive drug class in elderly patients is influenced not only by comorbid conditions present but also by socio-demographic and clinical characteristics, such as age, sex, living alone, polymorbidity and immobilization. These characteristics reflect the doctor's perception of risk from pharmacotherapy of hypertension in elderly patients.
Wawruch
Martin
M
Department of Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
Dukat
Andrej
A
Murin
Jan
J
Wsolova
Ladislava
L
Kuzelova
Magdalena
M
Macugova
Agata
A
Wimmer
Gejza
G
Shah
Rashmi
R
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D007103:Immobilization; D008297:Male; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012737:Sex Factors; D018154:Slovakia / Q000453:epidemiology; D012959:Socioeconomic Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents