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Cardiovascular disease in nonagenarians: Prevalence and utilization of preventive therapies.

Authors
  • Mostaza, Jose M1
  • Lahoz, Carlos1
  • Salinero-Fort, Miguel A2
  • Cardenas, Juan3
  • 1 1 Department of Internal Medicine. Hospital Carlos III, Madrid, Spain. , (Spain)
  • 2 2 Subdirección General de Investigación Sanitaria, Consejería de Sanidad, Madrid, Spain. , (Spain)
  • 3 3 Dirección Técnica de Sistemas de Información Sanitaria, Gerencia Adjunta de Procesos Asistenciales, Gerencia Asistencial de Atención Primaria, Madrid, Spain. , (Spain)
Type
Published Article
Journal
European Journal of Preventive Cardiology
Publisher
SAGE Publications
Publication Date
Nov 14, 2018
Identifiers
DOI: 10.1177/2047487318813723
PMID: 30426771
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Nonagenarians are a fast growing segment of industrialized countries' populations. Despite a greater risk of cardiovascular disease, there are limited data about their use of preventive therapies and factors guiding decisions regarding their prescription. The aim of this study was to evaluate the prevalence of cardiovascular diseases and the patterns of use of cardiovascular treatments in subjects ≥90 years old. Population-based, cross-sectional study, in all nonagenarians residing in the Community of Madrid (Spain). Data were obtained from their electronic clinical records in primary care. Data were available from 59,423 subjects (mean age 93.3 years, 74.2% female, 13.5% with dementia). Prevalence of cardiovascular disease was 24.1% (10.9% with coronary artery disease (CAD), 13.1% with cerebrovascular disease (CVD) and 2.7% with peripheral artery disease(PAD)). In primary prevention, the use of statins and antiplatelet agents was 21.9% and 26.7%, respectively. Of subjects with vascular disease 27.7% were receiving a combined preventive strategy (use of antithrombotics, plus statins, plus blood pressure below 140/90 mmHg). Factors favourably associated with a combined preventive strategy were: female sex (odds ratio (OR) 1.29; 95% confidence interval (CI): 1.11-1.49), being independent versus totally dependent (OR 1.94; 95% CI: 1.43-2.65), diabetes (OR 1.42; 95% CI: 1.20-1.68), and negatively, age (OR 0.87; 95% CI: 0.85-0.90), CVD versus CAD (OR 0.41; 95% CI: 0.35-0.47), PAD versus CAD (OR 0.23; 95% CI: 0.18-0.30), dementia (OR 0.61; 95% CI: 0.49-0.76) and nursing home residency (OR 0.73; 95% CI: 0.57-0.93). Nonagenarians have a great burden of cardiovascular diseases and receive a great number of preventive therapies, even in primary prevention, despite their unproven efficacy at these ages.

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