Geriatric issues of prescribing cardiovascular drugs in the elderly

Cardiovascular diseases impose a significant burden on society, including in older adults, in terms of mortality, morbidity, disability, functional decline, and health care costs. In addition, due to the growing elderly population, there is a growing need to improve their health and quality of life, as well as to promote optimal medication use. Increasing age is associated with higher rates of comorbidities, disability (cognitive, intellectual, and functional impairment), and the use of multiple medications. Age-associated changes affect cardiac performance by reducing cardiac elasticity and responsiveness to pressure changes. Involutional changes lead to multiple structural and functional changes in the cardiovascular system that may increase the susceptibility of aging individuals to the development of cardiovascular diseases, which represent the most common pathological conditions in older adults. Pharmacotherapy of cardiovascular diseases in the elderly is complex because age-related changes in body composition, organ function, homeostatic mechanisms, and comorbidities alter the pharmacokinetic and pharmacodynamic properties of many commonly used cardiovascular and non-cardiovascular drugs. Due to multiple chronic diseases and age-related physiological changes that affect the pharmacodynamic and pharmacokinetic properties of drugs, it can be concluded that the prescription of pharmacotherapy in the elderly is a complex and challenging task of the geriatric approach. Polypharmacy, non-adherence, inappropriate prescription of drugs, drug interactions, and drug-related problems are common in elderly patients with cardiovascular diseases. In this regard, the risk of adverse drug reactions is higher in elderly patients. The review article is devoted to the possibilities of prescribing cardiovascular drugs in elderly people, taking into account involutional changes in the body, polypharmacy, as well as problems associated with taking medications