Beauchesne Andrew B, Goldhamer Alan C, Myers Toshia R
Tufts University School of Medicine, Boston, Massachusetts, USA.
Nutritional Medicine, TrueNorth Health Center, Santa Rosa, California, USA.
BMJ Case Rep. 2018 Dec 17;11(1):e227059. doi: 10.1136/bcr-2018-227059.
Polypharmacy is common and associated with negative health outcomes in the elderly. We report the case of an 82-year-old man with a history of polypharmacy due to coronary artery disease, myocardial infarction, ischaemic cardiomyopathy, hyperlipidaemia, hypertension and persistent atrial fibrillation who presented with memory loss, cognitive impairment, fatigue and weakness. His treatment plan included an exclusively plant, whole-food diet and moderate physical activity which resulted in a rapid reduction of hyperlipidaemia and high blood pressure and the discontinuation of statin, antihypertensive and beta blocker drug therapy. The patient also reported reversal of impaired cognition and symptoms associated with atrial fibrillation and ischaemic cardiomyopathy, including light-headedness, fatigue and weakness. This case demonstrates that dietary and lifestyle modifications have the potential to improve symptoms of cardiovascular disease and reduce polypharmacy along with associated negative consequences in the elderly.
多重用药在老年人中很常见,且与不良健康后果相关。我们报告一例82岁男性病例,该患者因冠状动脉疾病、心肌梗死、缺血性心肌病、高脂血症、高血压和持续性心房颤动而有多重用药史,出现了记忆力减退、认知障碍、疲劳和虚弱症状。他的治疗方案包括完全基于植物的全食物饮食和适度体育活动,这导致高脂血症和高血压迅速减轻,他汀类药物、抗高血压药物和β受体阻滞剂药物治疗停用。患者还报告认知障碍以及与心房颤动和缺血性心肌病相关的症状(包括头晕、疲劳和虚弱)得到了逆转。该病例表明,饮食和生活方式的改变有可能改善心血管疾病症状,并减少老年人的多重用药及其相关不良后果。