A study has stressed the importance of prescribing drugs to patients aged 75 and above to help lower their risk of cardiovascular disease.
The researchers argue that older people are being "largely
ignored" by current guidance, yet as the population ages, greater use of these
drugs could reduce disability and prolong healthy life expectancy.
Cardiovascular diseases such as stroke, heart attack and
heart failure are the principal cause of death in the UK and around
the world. Drugs that help to lower blood pressure (antihypertensives) and
cholesterol levels (statins) are safe and effective, yet current guidelines for
preventing cardiovascular disease focus only on people aged 40-74 years.
Previous studies focusing on patients with existing
cardiovascular disease have also found that patients are less likely to receive
preventative treatment the older they get, despite the fact that the risk of
developing cardiovascular disease increases with age.
So a team of researchers 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, to establish whether age and sex impact
on prescriptions for antihypertensives and statins. None of the patients had a
history of cardiovascular disease at the start of the study.
Results show that the likelihood of using antihypertensive
medication increased with every five years but started to decline 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,
although 23% of all patients aged 75 and over were taking statins. Those aged
70-74 had the highest use. Women aged between 65-69 and 75-79 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 has shown that antihypertensive treatment in
those over 80 can reduce the risk of cardiovascular disease. The evidence for
statin treatment in the elderly is less clear because trials have not been
conducted in this population, but the authors say that there is no evidence to
suggest that prescribing statins in elderly patients causes any harm.
The authors conclude that the older population should not be
ignored when prescribing drugs to prevent cardiovascular disease. They suggest
that guidelines should be modified and future research should look at the use
of statin therapy in people aged 80 or more and that treating those aged 75 and
over with these drugs "could be an appropriate place to start".
This press release presents independent research funded by
the National Institute for Research (NIHR) through a Stroke Prevention Program
Grant and the Collaboration for Leadership in Applied Health Research and Care
for Birmingham and Black
Country. The views are not
necessarily those of the NHS, the NIHR or the Department of Health.