Elderly not getting treatment they need, study says
New European research shows that many patients aged 75 and over don't have access to the treatment they require to help lower their risk of cardiovascular disease (CVD).
Writing in the British Medical Journal, the team from the United Kingdom report that as the population continues to age, greater use of prescribed drugs could reduce disability and prolong healthy life expectancy. Drugs that help to lower blood pressure (antihypertensives) and cholesterol levels (statins) are safe and effective, yet many current guidelines for preventing cardiovascular disease only focus on people in the 40-74 years age bracket.
Cardiovascular diseases such as strokes and heart failure are among some of the biggest killers worldwide; according to the World Health Organization (WHO) by 2030 almost 23.6 million people will die from cardiovascular diseases.
Drawing on work carried out in previous studies that show that patients are less likely to receive preventative treatment the older they get, despite the fact that the risk of developing cardiovascular disease exponentially increases with age, the team, from the University of Birmingham and the University of Oxford, studied 36,679 patients aged 40 and over from 19 general practices in the West Midlands.
The aim was to establish whether age and sex impact on prescriptions for antihypertensives and statins. At the start of the study none of the patients had a reported history of cardiovascular disease.
The findings showed that the likelihood of using antihypertensive medication increased with every five years that passed but started to decline again after the age of 85. Patients aged 75 and over had the highest use overall (56%) and women were 10% more likely to be taking antihypertensives than men.
The likelihood of using statin medication also increased with every five years but decreased with every five years after the age of 75. Of all patients aged 75 and over, 23% were taking statins. Those aged 70-74 had the highest use.
Women aged between 65 and 69 and 75 and 79 were 5% more likely to be issued a prescription than men, whilst men under the age of 60 were more likely to be issued a prescription.
A 2008 study showed that antihypertensive treatment in those over 80 can reduce the risk of cardiovascular disease. Although the evidence surrounding the benefits of statin treatment in the elderly is less clear-cut as trials have not been conducted yet among this segment of the population, the authors report that there is no evidence to suggest that prescribing statins in elderly patients causes any harm.
The implications of this study are that the elderly should not be sidelined when it comes to the prescription of drugs to prevent cardiovascular disease. The researchers suggest that guidelines should be modified and future research should look at the use of statin therapy in people aged 80 or over. They also state that treating those aged 75 and over with these drugs would be a step in the right direction.
For more information, please visit:
British Medical Journal:
Data Source Provider: British Medical Journal
Document Reference: Sheppard, J.P., et al. 'Impact of age and sex on primary preventive treatment for cardiovascular disease in the West Midlands, UK: cross sectional study', BMJ, 2012. doi:10.1136/bmj.e4535
Subject Index: Coordination, Cooperation; Life Sciences; Medicine, Health; Scientific Research