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The effect of selected patient's characteristics on the choice of antihypertensive medication in the elderly in Slovakia
Author(s) -
Wawruch Martin,
Dukat Andrej,
Murin Jan,
Wsolova Ladislava,
Kuzelova Magdalena,
Macugova Agata,
Wimmer Gejza,
Shah Rashmi
Publication year - 2009
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1839
Subject(s) - medicine , drug class , medical prescription , antihypertensive drug , odds ratio , angiotensin converting enzyme , drug , pharmacoepidemiology , ace inhibitor , retrospective cohort study , dihydropyridine , blood pressure , pharmacology , calcium
Purpose The aim of the present study was to determine which patient‐related characteristics influence the selection of the antihypertensive drug class in elderly patients in Slovakia. Methods The sample for our study ( n = 401) was selected from 1045 patients admitted to the Department of Internal Medicine of a general hospital during the period of 1 December 2003—31 March 2005. Patients aged 65 or more with documented arterial hypertension and treated with at least one antihypertensive drug were enrolled in our retrospective study. Specific socio‐demographic and clinical characteristics as well as cardiovascular comorbid conditions were evaluated as potential factors that could have influenced the choice of antihypertensive drug class. Results The most frequently prescribed antihypertensive drugs were angiotensin‐converting enzyme (ACE) inhibitors and diuretics (61.8% and 60.1% of patients, respectively). Patients aged ≥ 85 years had lower probability of ACE inhibitors prescription (OR = 0.49). Females had higher chance of calcium channel blockers use (OR = 3.84) and lower odds of diuretics administration (OR = 0.50). In patients living alone, ACE inhibitors were preferred (OR = 2.16). The use of diuretics was more frequent in polymorbid patients (OR = 1.95). Immobile patients had lower chance of being prescribed beta‐blockers and calcium channel blockers (OR = 0.25 and OR = 0.39, respectively). Conclusion The present study revealed that the selection of the antihypertensive drug class in elderly patients is influenced not only by comorbid conditions present but also by socio‐demographic and clinical characteristics, such as age, sex, living alone, polymorbidity and immobilization. These characteristics reflect the doctor's perception of risk from pharmacotherapy of hypertension in elderly patients. Copyright © 2009 John Wiley & Sons, Ltd.