Trends in drug usage among elderly with cardiovascular diseases

Rajeshwari Shastry, Yugandhar Bethi, Sowjanya ., Jammula Uday Kumar


Background: Cardiovascular disease (CVD) is a common health problem in the world and a major cause of premature morbidity and mortality in the elderly. Various combinations of drugs are used for the management of CVD. Hence, the present study was conducted to analyze the drug usage trends in elderly with CVDs.

Methods: A retrospective cross-sectional descriptive study was conducted for a period of 6 months in an outpatient department at a tertiary care teaching hospital. The medical records of elderly (age ≥60 years) patients with CVDs were reviewed. Drug prescribed mainly for hypertension, ischemic heart disease (IHD), congestive cardiac failure (CCF) were included along with drugs used for other co-morbidities. The results were analyzed using descriptive statistics.

Results: Of 234 elderly patients, 124 (53%) were males and 110 (47%) were females. Hypertension was found in 208 (88.9%) patients, 66 (28.2%) had IHD and 4 (1.7%) had CCF. Drugs used for CVDs were beta blockers (BB) (30.77%), calcium channel blockers (CCB) (39.32%), angiotensin receptor blockers (ARB) (24.36%), angiotensin converting enzyme inhibitors (ACEIs) (20.94%) and diuretics (16.67%). Nitrates were prescribed for 66 (28.20%) patients and antiplatelet agents such as aspirin and clopidogrel were prescribed in 80 (34.19%) patients. Diabetes mellitus was found in 114 (48.7%) patients, 26 (11.1%) had bronchial asthma, followed by hyperlipidemia (3.8%), arthritis (3.8%), cerebrovascular accident (1.7%), and peripheral neuropathy, retinopathy and hypothyroidism was noted in 2 (0.9%) patients each.

Conclusion: Among the antihypertensive groups CCBs were the most commonly used followed by BB, ARBs and ACEIs. Among these antihypertensive agents amlodipine, losartan, atenolol and enalapril were most commonly used. Commonly used antidiabetic agents were metformin and glimepiride.


Elderly, Cardiovascular diseases, Hypertension, Ischemic heart disease, Congestive cardiac failure, Diabetes mellitus

Full Text:



Dhar HL. Emerging geriatric challenge. J Assoc Physicians India. 2005;53:867-72.

Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics-2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):480-6.

Al-Amin M, Zinchenko A, Rana S, Uddin MN, Pervin S. Study on polypharmacy in patients with cardiovascular diseases. J Appl Pharm Sci. 2012;2(12):53-60.

Psaty BM, Savage PJ, Tell GS, Polak JF, Hirsch CH, Gardin JM, et al. Temporal patterns of antihypertensive medication use among elderly patients. The Cardiovascular Health Study. JAMA. 1993;270(15):1837-41.

Qato DM, Lindau ST, Conti RM, Schumm LP, Alexander GC. Racial and ethnic disparities in cardiovascular medication use among older adults in the United States. Pharmacoepidemiol Drug Saf. 2010;19(8):834-42.

Rodgers A, Lawes C, MacMahon S. Reducing the global burden of blood pressure-related cardiovascular disease. J Hypertens Suppl. 2000;18(1):S3-6.

Zaveri HG, Mansuri SM, Patel VJ. Use of potentially inappropriate medicines in elderly: a prospective study in medicine out-patient department of a tertiary care teaching hospital. Indian J Pharmacol. 2010;42(2):95-8.

Tiwari H, Kumar A, Kulkarni SK. Prescription monitoring of anti-hypertensive drug utilisation at the Panjab University Health Centre in India. Singapore Med J. 2004;45(3):117-20.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-52.

Gibson MV, Fritz J, Kachur V. Practical strategies for management of hypertension in the elderly. Geriatrics. 2009;64(10):10-9.

Sander GE, Giles TD. Thiazide diuretics and b-blockers in the treatment of hypertension in diabetes mellitus. J Clin Hypertens. 2011;13(4):296-300.