OBJECTIVE: To evaluate the sociodemographic, clinical characteristics and prevalence of medications used by elderly patients with cardiovascular diseases, addressing the difference between users of the single health care system (SUS) and private/covenant during hospitalization. Methods: A retrospective cross-sectional study was carried out in a large hospital in Porto Alegre, by reviewing medical records of patients hospitalized at the coronary care units in the period from January to December 2015. The sample consisted of the evaluation of 152 medical records, the collection was performed through a specific semi-structured instrument. RESULTS: A total of 68 elderly patients belonged to the SUS user group. The other 84 medical records were users of several Covenants / Individuals groups. Regarding lifestyle, it was shown that smoking was representative. The presence of a significant association Regarding the clinical profile, all patients in both groups were hospitalized in coronary care units. CONCLUSIONS: It is concluded that the patients in the private / covenants group use a greater number of drugs outside the National Essential Medicines report than those in the SUS group. The SUS group stands out for being more hypertensive and smokers and as a result, they perform more hospitalizations with more severe pathologies when compared to the other group. These comparative data highlight the importance of actions that aim to balance the differences between the modalities of health plans served in Brazil.