Schulz Martin, Trenk Dietmar, Laufs Ulrich
Institut für Pharmazie, Freie Universität Berlin, Berlin, Deutschland.
Arzneimittelkommission der Deutschen Apotheker (AMK), Heidestr. 7, 10557, Berlin, Deutschland.
Herz. 2023 Aug;48(4):325-336. doi: 10.1007/s00059-023-05191-5. Epub 2023 Jun 12.
Cardiovascular diseases are the most frequent cause of disability and death. Evidence-based pharmacotherapy is the basis for successful treatment of common diseases, such as hypertension, heart failure, coronary artery disease, and atrial fibrillation. The proportion of older people with several diseases (multimorbidity) who need five or more drugs daily (polypharmacy) is steadily increasing. Evidence on the efficacy and safety of drugs in these patients is, however, limited because they are often excluded or underrepresented in clinical trials. In addition, clinical guidelines mostly focus on single diseases and only occasionally deal with the challenges in the pharmacotherapy of older multimorbid patients with polypharmacy. This article describes the options and special features of pharmacotherapy for hypertension, chronic heart failure and dyslipidemia, as well as antithrombotic treatment in (very) old people.
心血管疾病是导致残疾和死亡的最常见原因。循证药物治疗是成功治疗常见疾病(如高血压、心力衰竭、冠状动脉疾病和心房颤动)的基础。每天需要服用五种或更多药物(多重用药)的患有多种疾病(共病)的老年人比例正在稳步上升。然而,由于这些患者在临床试验中常常被排除或代表性不足,关于药物在这些患者中的疗效和安全性的证据有限。此外,临床指南大多关注单一疾病,很少涉及老年多重共病且多重用药患者药物治疗中的挑战。本文描述了高血压、慢性心力衰竭和血脂异常的药物治疗选择及特点,以及(极)老年人的抗栓治疗。