Abstract
Objectives
Cardiovascular diseases are mainly related to hypertension and dyslipidemia and increase
with aging because of the larger time span for these risk factors to damage arterial
blood vessels. The impact of cardiovascular drug therapy on outcomes in the very elderly
hospitalized is still not well established. The aim of our study was to evaluate the
associations between cardiovascular therapy and in-hospital mortality in very elderly
hypertensives.
Design
Prospective observational study.
Setting
Hospital assessment.
Participants
310 very elderly hypertensive patients admitted to our Internal Medicine and Geriatrics
Department for medical conditions.
Measurements
Main comorbidities, laboratory parameters, and cardiovascular drug therapy taken before
admission were considered for the analyses.
Results
The mean age was 88.1 ± 5.1 years, with female prevalence of 57.4%. Among cardiovascular
drugs taken before admission, angiotensin-converting enzyme (ACE) inhibitors/angiotensin
receptor blockers and statins were those associated with lower in-hospital mortality,
even after adjusting for covariates (age, hemoglobin, albumin, acute kidney injury,
ADL Hierarchy Scale, NT-proBNP levels) [odds ratio (OR) = 0.46, P = .045, and OR = 0.21, P = .008, respectively]. No difference regarding in-hospital mortality was found between
ACE inhibitors and angiotensin receptor blockers (P = .414).
Conclusion
ACE inhibitors/angiotensin receptor blockers and statins, through their beneficial
effects on the cardiovascular system, have a positive impact on survival in very elderly
hospitalized patients. Our data confirm the important role of such drugs even in this
particular population with a mean age higher than 88 years, where scientific evidence
is still scanty.
Keywords
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Article info
Publication history
Published online: November 08, 2017
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
