Optimal Dosage of ACE Inhibitors in Older Patients

Tomlinson, Brian

doi:10.2165/00002512-199609040-00004

Cited by 12 publications

(6 citation statements)

References 89 publications

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“…Zu Bedenken ist jedoch eine potenzielle Erhöhung der Plasmakonzentrationen der Substanzen aufgrund einer möglichen Nierenfunktionseinschränkung. Dies kann bei älteren Patienten in Kombination mit einer verminderten oder verzögerten kardiovaskulären Kompensationsfähigkeit zu einer erhöhten Inzidenz von Hypotensionen bei der Erstgabe dieser Substanzen führen (23). Durch die vorläufige Unterbrechung einer Diuretikatherapie kann diese Nebenwirkung möglicherweise vermieden werden (23).…”

Section: Generell Gilt: Raas-blockade Ist Empfehlenswertunclassified

Kardiovaskuläre Pharmakotherapie im Alter am Beispiel der Herzinsuffizienz - Im Fokus steht ein ereignisfreies und unabhängiges Überleben

Baumhäkel¹,

Böhm²

2007

Klinikarzt

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Section: Generell Gilt: Raas-blockade Ist Empfehlenswertunclassified

Kardiovaskuläre Pharmakotherapie im Alter am Beispiel der Herzinsuffizienz - Im Fokus steht ein ereignisfreies und unabhängiges Überleben

Baumhäkel¹,

Böhm²

2007

Klinikarzt

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“…Long-term treatment may be prescribed unnecessarily with all the risks derived from potential treatment-emergent adverse reactions [78-80]. …”

Section: White Coat Hypertension (Wch)mentioning

confidence: 99%

The Blood Pressure "Uncertainty Range" – a pragmatic approach to overcome current diagnostic uncertainties (II)

Pater

2005

Trials

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A tremendous amount of scientific evidence regarding the physiology and physiopathology of high blood pressure combined with a sophisticated therapeutic arsenal is at the disposal of the medical community to counteract the overall public health burden of hypertension. Ample evidence has also been gathered from a multitude of large-scale randomized trials indicating the beneficial effects of current treatment strategies in terms of reduced hypertension-related morbidity and mortality.In spite of these impressive advances and, deeply disappointingly from a public health perspective, the real picture of hypertension management is overshadowed by widespread diagnostic inaccuracies (underdiagnosis, overdiagnosis) as well as by treatment failures generated by undertreatment, overtreatment, and misuse of medications.The scientific, medical and patient communities as well as decision-makers worldwide are striving for greatest possible health gains from available resources.A seemingly well-crystallised reasoning is that comprehensive strategic approaches must not only target hypertension as a pathological entity, but rather, take into account the wider environment in which hypertension is a major risk factor for cardiovascular disease carrying a great deal of our inheritance, and its interplay in the constellation of other, well-known, modifiable risk factors, i.e., attention is to be switched from one's "blood pressure level" to one's absolute cardiovascular risk and its determinants. Likewise, a risk/benefit assessment in each individual case is required in order to achieve best possible results.Nevertheless, it is of paramount importance to insure generalizability of ABPM use in clinical practice with the aim of improving the accuracy of a first diagnosis for both individual treatment and clinical research purposes. Widespread adoption of the method requires quick adjustment of current guidelines, development of appropriate technology infrastructure and training of staff (i.e., education, decision support, and information systems for practitioners and patients). Progress can be achieved in a few years, or in the next 25 years.

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“…Die Plasmareninkonzentrationen sind bei älteren Patienten häufig niedriger als bei jüngeren Individuen.Darüber hinaus sind die Plasmakonzentrationen der ACEHemmer/AT 1 -Rezeptorantagonisten aufgrund einer möglichen Nierenfunktionseinschränkung oftmals erhöht.Dies kann bei älteren Patienten in Kombination mit einer verminderten oder verzögerten kardiovaskulären Kompensationsfähigkeit zu einer erhöhten Inzidenz einer Hypotension bei der Erstgabe dieser Substanzen führen [43].Durch die vorläufige Unterbrechung einer Diuretikatherapie kann diese Nebenwirkung möglicherweise vermieden werden [43].…”

Section: Ace-hemmer Und At 1 -Rezeptorantagonistenunclassified

Kardiovaskul�re Pharmakotherapie im Alter

Baumhäkel

Böhm

2003

Der Internist

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Prevalence of cardiovascular diseases increases with advancing age. Moreover, these patients are getting older and older. Therefore, pharmacotherapy of the elderly becomes a major objective in clinical cardiology. Pharmacodynamic and pharmacokinetic changes in the elderly can interfere with a sufficient treatment of cardiovascular diseases and moreover, multiple drug usage is a considerable risk factor of possible drug-drug interactions. Furthermore, treatment of cardiovascular diseases as hypertension, heart failure or coronary heart disease in the elderly according to the international guidelines is often limited due to co-morbidities restricting usage of the appropriate medication. This review addresses both, the treatment of cardiovascular diseases in the elderly and the pharmacological characteristics of frequently used drugs.

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Optimal Dosage of ACE Inhibitors in Older Patients

Cited by 12 publications

References 89 publications

Kardiovaskuläre Pharmakotherapie im Alter am Beispiel der Herzinsuffizienz - Im Fokus steht ein ereignisfreies und unabhängiges Überleben

Kardiovaskuläre Pharmakotherapie im Alter am Beispiel der Herzinsuffizienz - Im Fokus steht ein ereignisfreies und unabhängiges Überleben

The Blood Pressure "Uncertainty Range" – a pragmatic approach to overcome current diagnostic uncertainties (II)

Kardiovaskul�re Pharmakotherapie im Alter

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