USE OF CARDIOVASCULAR DRUGS IN AN OLDER SWEDISH POPULATION

OBJECTIVE: To describe the use of cardiovascular drugs in an older pop ulation with respect to age, sex, housing type, and creatinine clearan ce. DESIGN: A cross-sectional survey. PARTICIPANTS: All residents of a district of Stockholm (Kungsholmen), Sweden, aged 75 and older, livin g in institutions or at home. MEASUREMENTS: Cardiovascular drug use, s erum creatinine, electrolytes, height, weight, and symptoms RESULTS: A total of 43 cardiovascular (CV) drugs were used. The most common drug s were digoxin (used by 18.2%), furosemide (16.4%), and glyceryl trini trate (12.4%). Drugs with an antihypertensive effect accounted for 61% of all CV drugs. CV drug use increased with ape for cardiac glycoside s and diuretics, but decreased with age for calcium antagonists and be ta-blockers. Drug doses tended to be less than the recommended daily d ose except for a few drugs, e.g., furosemide. There was a trend toward decreasing dose with increasing age, but this was not significant. Di uretics were the only CV drugs used more often in women. People living in institutional care used the least amount of CV drugs. The dose of drugs taken did not appear to be related to estimated creatinine clear ance. Comparisons between drug use and complaint of symptoms showed a strong correlation between the use of cardiac glycosides and anorexia, calcium antagonists and constipation, and nitrates and vertigo. There were weaker correlations with cardiac glycosides and visual disturban ces and with potassium sparing diuretics and a high potassium. CONCLUS IONS: CV drugs are used commonly in older people. We suggest that the symptoms correlating with cardiac glycoside use may be signs of unreco gnized toxicity, and this may relate to our finding that drug use is o ften not tailored to renal function as measured by creatinine clearanc e.