Altered pharmacodynamics of cardiovascular drugs and their relation to altered pharmacokinetics in elderly patients.

To properly predict drug effects in elderly patients for cardiovascular drugs requires understanding of age-related and disease-related changes in tissues and organs which mediate the observed pharmacodynamic response. Linking this understanding with the known changes in drug pharmacokinetics permits more effective cardiovascular pharmacotherapy in the geriatric patient. At the present time only a limited number of drug classes have been studied in this manner. Although it may be intuitively obvious that human pathophysiology may impact on drug response, until recently we have relied solely on description of drug concentration or pharmacokinetics to predict expected responses. We can look forward to improved geriatric therapeutics when the patient as well as the drug is considered as a variable in clinical therapeutic responses.