Oral anticoagulant and antiplatelet drugs used in prevention of cardiovascular events in elderly people in Poland
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Abstract:
In Poland, the prevalence of cardiovascular diseases is increasing. This might be associated with the constantly growing proportion of elderly people and inappropriate cardiovascular prevention. This study aimed to evaluate the frequency of use of oral antiplatelet (OAP) and oral anticoagulant (OAC) drugs among older people in Poland and to assess their association with cardiovascular risk factors. The study was based on data collected during the implementation of a multicentre, publicly funded research project called PolSenior. The study group consisted of 4,979 people with the average age of 79.35 ± 8.69 years. Among them, 1,787 people (35.9%) used at least one drug in the prevention of cardiovascular diseases. OAPs were used regularly by 1,648 (33.1%) elderly people and OACs were used by 165 elderly people (3.3%). Acetylsalicylic acid was used by 32.2% of elderly people. Use of drugs significantly depended on age (p < 0.01), sex (p < 0.01), place of residence (p < 0.001), level of education (p < 0.0001) and personal income (p < 0.0001). Among all the respondents treated with OAPs, therapy was applied as secondary cardiovascular prevention in 717 respondents (43.5%), and as primary prevention in 705 respondents (42.8%). Among the respondents treated with OACs, 117 (71%) elderly people had a history of atrial fibrillation. Secondary cardiovascular prevention should be considered in a further 482 respondents (15.1% of untreated elderly people), and primary cardiovascular prevention in 1,447 respondents (45.3%). Our study is the first to determine the frequency of use of OAP and OAC drugs among elderly people in Poland in relation to cardiovascular risk factors. The most commonly used drug for cardiovascular prevention is acetylsalicylic acid, but it appears that it is used too rarely in high-risk patients. Educational programs should be developed among general practitioners concerning current recommendations for pharmacological cardiovascular prevention.Keywords:
Elderly people
Angiology
Secondary Prevention
Primary Prevention
Oral anticoagulant
Diet plays a major role in cardiovascular disease (CVD) risk. To determine the effectiveness of a Mediterranean-style diet for the primary and secondary prevention of CVD. We searched for randomised controlled trials (RCTs) of Mediterranean-style diets in healthy adults and those at increased risk of CVD (primary prevention) and with established CVD (secondary prevention). Thirty RCTs were included, 22 in primary prevention and eight in secondary prevention. Clinical endpoints were reported in two trials where there was moderate quality evidence for a reduction in strokes for primary prevention, and low quality evidence for a reduction in total and CVD mortality in secondary prevention. We found moderate quality evidence of improvement in CVD risk factors for primary prevention and low quality evidence of little or no effect in secondary prevention. There is still some uncertainty regarding the effects of a Mediterranean-style diet in CVD prevention.
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Secondary Prevention
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Low-dose acetylsalicylic acid (ASA) for prevention of cardiovascular disease (CVD), including myocardial infarction (MI) and stroke, is likely something that comes up frequently at family physician appointments. Acetylsalicylic acid has substantial benefits for secondary prevention in most cases.
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Coronary disease
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Source Citation Grover SA, Paquet S, Levinton C, Coupal L, Zowall H. Estimating the benefits of modifying risk factors of cardiovascular disease. A comparison of primary vs secondary prevention. Arch Intern Med. 1998 Mar 23;158:655-62.
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