Kardiovaskuläre Pharmakotherapie im Alter am Beispiel der Herzinsuffizienz - Im Fokus steht ein ereignisfreies und unabhängiges Überleben

Aufgrund der Veränderung der Altersstruktur in den westlichen Industrieländern steigt auch die Prävalenz kardiovaskulärer Erkrankungen. Ältere Patienten erfüllen jedoch aufgrund ihres Alters bzw. vorliegender Komorbiditäten häufig nicht die Einschlusskriterien kontrollierter Studien. Eine evidenzbasierte Pharmakotherapie scheint daher nur eingeschränkt möglich zu sein, mehrere Studien konnten jedoch in den letzten Jahren auch bei älteren Patienten den Nutzen der medikamentösen Therapie dokumentieren. Darüber hinaus können pharmakodynamische und pharmakokinetische Veränderungen im Alter eine adäquate Therapie kardiovaskulärer Erkrankungen erschweren. Dieser Artikel stellt exemplarisch die Therapie der chronischen Herzinsuffizienz im Hinblick auf den älteren Patienten anhand aktueller Daten dar.

As a result of changes in the population age spectrum in the Western industrial countries there is also an increase in the prevalence of cardiovascular diseases. However, aged patients are often not included in the statistical criteria of surveys either because of their age or due to other associated diseases whenever controlled studies are performed. Hence, it appears that evidence-based pharmacotherapy is not unequivocally possible, although several studies conducted during the past few years did confirm the adequacy of on-target medicotherapy in the elderly. Over and above this there may be pharmacodynamic and pharmacokinetic changes in aged persons that may make it rather difficult to conduct an adequate treatment of cardiovascular diseases. That is why the present article focuses on exemplary therapy of chronic heart failure in the elderly, based on update data.

Key words

cardiovascular pharmacotherapy - elderly - heart failure

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1 Heart Outcomes Prevention Evaluation

2 Assessment of Treatment with Lisinopril And Survival

3 Valsartan HEart Failure Trial

4 Candesartan in Heart Failure Assessement of Reduction in Mortality and Morbidity

5 MEtoprolol CR/XL Randomized Intervention Trial in chronic Heart Failure

6 Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalisation in Seniors

7 CarvedilOl ProspectivE RaNdomIzed CUmulative Survival

8 Cardiac Insufficiency Bisoprolol Study

9 Randomized Aldactone Evaluation Study

10 Eplerenone Post AHI Heart failure Efficacy and SUrvival Study

11 Digitalis Investigator Group

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