Dornbrook-Lavender Kimberly A, Roth Mary T, Pieper John A
Division of Pharmacotherapy, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Ann Pharmacother. 2003 Dec;37(12):1867-76. doi: 10.1345/aph.1D026.
To review relevant literature supporting the use of aspirin, beta-blockers, lipid-lowering agents, and angiotensin-converting enzyme (ACE) inhibitors for the secondary prevention of coronary heart disease (CHD) in an elderly patient population aged >/=65 years.
A MEDLINE search (1990-May 2003) was conducted using the key terms coronary heart disease, secondary prevention and elderly.
Primary and tertiary literature relating to the use of aspirin, beta-blockers, lipid-lowering agents, and ACE inhibitors in the elderly were reviewed.
CHD is the leading cause of morbidity and mortality in persons >/=65 years of age, and the use of pharmacologic agents has created a considerable opportunity for reducing recurrent events in those with established disease. This, combined with the aging of the US population, is creating an increase in the number of older adults eligible for secondary prevention. In 2002, the American Heart Association issued a scientific statement on the benefits of specific secondary prevention risk factor interventions in older adults. This article reviews pertinent findings from this statement, along with additional data supporting the use of pharmacologic agents for the secondary prevention of CHD in the elderly.
Data suggest that use of aspirin, beta-blockers, lipid-lowering agents, and ACE inhibitors are effective in secondary prevention of CHD in individuals aged >/=65 years. This benefit is similar to, and often greater than, that observed in younger patients. We believe that these agents should be prescribed for all elderly patients without contraindications. Ongoing studies and future clinical trials will more clearly elucidate the benefits of secondary prevention of CHD, particularly in persons >/=75 years of age, to determine the magnitude of benefits that can be achieved in this population.
回顾相关文献，以支持在年龄≥65岁的老年患者群体中使用阿司匹林、β受体阻滞剂、降脂药物和血管紧张素转换酶（ACE）抑制剂进行冠心病（CHD）二级预防。
使用关键词“冠心病”“二级预防”和“老年人”对MEDLINE数据库进行检索（1990年至2003年5月）。
对有关老年人使用阿司匹林、β受体阻滞剂、降脂药物和ACE抑制剂的一级和三级文献进行综述。
冠心病是≥65岁人群发病和死亡的主要原因，使用药物制剂为降低已患疾病者的复发事件创造了相当大的机会。这与美国人口老龄化相结合，使得符合二级预防条件的老年人数量增加。2002年，美国心脏协会发表了一份关于老年患者特定二级预防危险因素干预益处的科学声明。本文回顾了该声明中的相关研究结果，以及支持在老年人中使用药物制剂进行冠心病二级预防的其他数据。
数据表明，使用阿司匹林、β受体阻滞剂、降脂药物和ACE抑制剂对≥65岁个体的冠心病二级预防有效。这种益处与年轻患者相似，且往往更大。我们认为，对于所有无禁忌证的老年患者都应开具这些药物。正在进行的研究和未来的临床试验将更清楚地阐明冠心病二级预防的益处，特别是在≥75岁的人群中，以确定该人群可实现的益处程度。
