2025-04-22
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Cardiovascular disease (CVD) is the leading cause of mortality worldwide, and its prevalence increases significantly with age. Managing CVD in older adults presents a unique set of challenges due to physiological changes, the presence of comorbidities, and the risk of adverse drug events (ADEs) linked to polypharmacy. For clinicians, balancing the need for effective CVD treatments with the goal of minimizing medication-related risks is critical to ensuring optimal patient outcomes.
This blog explores the complexities of managing CVD in older adults, with a focus on the safe use of medications, strategies to mitigate polypharmacy, and tools that can streamline care for this population.
Older adults account for a disproportionate number of hospitalizations due to CVD. Factors contributing to the increased risk in this population include age-related changes in cardiovascular physiology, impaired organ function (e.g., kidneys and liver), and a higher prevalence of comorbidities such as diabetes, hypertension, and chronic kidney disease.
The burden extends beyond physical health. Untreated or inadequately managed CVD can lead to reduced quality of life, loss of independence, and strain on healthcare systems.
Understanding these challenges underscores the need for tailored, patient-centric approaches to disease management.
Polypharmacy, typically defined as the concurrent use of multiple medications, is a common and clinically significant concern in older adults with cardiovascular disease (CVD). While necessary to address various comorbid conditions, polypharmacy introduces the following risks:
For clinicians, mitigating these risks requires comprehensive medication management strategies.
Regular, detailed medication reviews are foundational to reducing polypharmacy risks. These reviews involve assessing the necessity, effectiveness, and safety of every prescribed medication. Adjustments should be made based on the patient’s current health status and treatment goals.
Risk assessment tools are invaluable for tailoring treatment decisions to the specific risk profiles of older adults. Some widely used tools include:
Using these tools facilitates shared decision-making and helps clinicians balance the risks and benefits of treatment options.
Deprescribing is a crucial strategy in polypharmacy management. Clinicians should consider discontinuing medications that no longer provide significant benefit, have limited evidence of efficacy in older populations, or increase the risk of ADEs.
Effective communication between clinicians and patients is key to managing CVD. Older adults should feel empowered to discuss their medications, voice concerns, and collaborate on treatment plans. Educating patients about the importance of medication adherence and providing tools such as medication reminders or blister packs can significantly improve outcomes.
While the focus on pharmacological interventions is critical, emphasizing lifestyle changes can help reduce the need for additional medications. Key recommendations for older adults include:
Regular follow-up visits are essential to monitor the effectiveness of treatment, detect any adverse events, and adjust medications as needed. Collaborative care among healthcare providers ensures continuity and consistency in CVD management.
Managing CVD in older adults is not about choosing between effective treatments and minimizing risks but rather finding the right balance between the two. Through meticulous medication management, patient engagement, and the integration of evidence-based tools, healthcare providers can optimize outcomes for this vulnerable population.
Learn more about managing CVD risk in older adults in this 15-minute Mainpro+ accredited course, CVD Risk in Older Adults: Strategies for Safer Medication Use.
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