Trends in prescribing ACE-inhibitors for congestive heart failure in elderly people.

Abstract

BACKGROUND AND AIMS:

The aim of this study was to analyze trends in the use of ACE-inhibitors in patients aged 65 and older with congestive heart failure (CHF) in the period from 1988 to 1998.

METHODS:

We studied 2985 patients (mean age 79.7 +/- 7 years), hospitalized for CHF in 12 different bimonthly periods. Home therapy prior to hospitalization was assessed retrospectively, and data on in-hospital therapy and discharge prescriptions were collected prospectively.

RESULTS:

Diuretics and digitalis were the most commonly used and prescribed drugs. The use of ACE-inhibitors between 1988 and 1998 increased from 13.4 to 46.7% prior to hospitalization, and from 25.8 to 59.2% as a discharge prescription. The most important factors associated with a prescription of ACE-inhibitors at discharge were previous use (OR 4.35, 95% CI=3.65-5.19), hypertension (OR 1.76, 95% CI=1.47-2.11), valvular heart diseases (OR 2.06, 95% CI=1.51-2.81) and diabetes (OR 1.58, 95% CI=1.29-1.93). Physical impairment was associated with a decreased use of ACE-inhibitors at discharge (OR 0.55, 95% CI=0.45-0.67).

CONCLUSIONS:

The use of ACE-inhibitors for the treatment of CHF progressively increased both at home and in hospital wards of general medicine and geriatrics in the 10-year period studied. Nevertheless, digitalis and diuretics continue to be the most commonly prescribed drugs. A widespread educational effort is needed to increase physicians' awareness of the rationale for prescribing ACE-inhibitors for CHF patients.

• Authors: Raffaele Antonelli Incalzi, Claudio Pedone, Marco Pahor, Graziano Onder, P U Carbonin, Gruppo Italiano di Farmacovigilanza nell'Anziano
• Journal: Aging clinical and experimental research (Aging Clin Exp Res) Vol. 14 Issue 6 Pg. 516-21 (Dec 2002) ISSN: 1594-0667 [Print] Germany
• PMID: 12674493 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Digitalis Glycosides
• Diuretics

Topics

• Aged
• Aged, 80 and over
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Data Collection
• Digitalis Glycosides (therapeutic use)
• Diuretics (therapeutic use)
• Drug Utilization
• Heart Failure (drug therapy)
• Humans
• Practice Patterns, Physicians' (trends)