Mangoni Arduino A
Department of Clinical Pharmacology, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
Drugs Aging. 2005;22(11):913-41. doi: 10.2165/00002512-200522110-00003.
An increasing number of elderly patients are exposed to cardiovascular drugs for the treatment of acute and/or chronic conditions. This is a result of the progressive aging of the population, a common feature in most industrialised countries, and an improvement in primary and secondary cardiovascular prevention strategies with increased survival rates. Traditionally, most elderly patients receiving cardiovascular drugs had advanced cardiac, liver and kidney disease that significantly influenced drug pharmacokinetic and pharmacodynamic parameters. Currently, however, many patients without significant organ impairment receive cardiovascular therapy for primary or early secondary prevention (i.e. increased vascular risk, asymptomatic left ventricular dysfunction, poststroke phase, type 2 diabetes mellitus), highlighting the need for a better understanding of specific age-related pharmacokinetic and pharmacodynamic effects. A systematic review has been conducted on the specific effects of aging, in the absence of major co-morbidities, on the pharmacokinetic and pharmacodynamic properties of traditional and newer cardiovascular drugs. Currently, the evidence available is poor or nonexisting for several drugs and mainly derived from very small and underpowered studies, thus limiting data interpretation. In particular, there is very little information on patients >80 years of age, thus raising important concerns about the correct use of these drugs in this constantly growing population.
越来越多的老年患者因治疗急性和/或慢性疾病而使用心血管药物。这是人口老龄化进程的结果，这在大多数工业化国家是一个普遍特征，同时也是一级和二级心血管预防策略改善以及生存率提高的结果。传统上，大多数接受心血管药物治疗的老年患者患有严重的心脏、肝脏和肾脏疾病，这显著影响了药物的药代动力学和药效学参数。然而，目前许多没有明显器官损害的患者接受心血管治疗以进行一级预防或早期二级预防（即血管风险增加、无症状左心室功能障碍、中风后阶段、2型糖尿病），这凸显了更好地了解特定年龄相关药代动力学和药效学效应的必要性。针对在无主要合并症情况下衰老对传统和新型心血管药物的药代动力学和药效学特性的具体影响进行了一项系统评价。目前，几种药物的现有证据不足或不存在，且主要来自非常小且效力不足的研究，因此限制了数据解读。特别是，关于80岁以上患者的信息非常少，因此对于在这个不断增长的人群中正确使用这些药物引发了重要担忧。
