Trends in Antihypertensive Drugs Used for Elderly Patients

Abstract

The administration of antihypertensive medications in the elderly (65 y.o. or more, 269 pts) was compared to that in younger cases (less than 65 y.o., 348 pts). All were outpatients who visited our clinic in 1990. The number of patients on a single therapeutic regimen was almost equal in both age groups. Once-a-day regimens were more common in the young (56.9% vs 48.3%, p<0.05), and three times-a-day regimens were more common in the elderly (14.7% vs 23.1%, p<0.01). The choice of antihypertensive drugs in patients with single therapy or combined therapy in the young was β blockers in 49.7%, Ca blockers in 39.4%, diuretics in 30.7% and ACE inhibitors in 17.8%, and those in the elderly were Ca blockers in 46.1%, diuretics in 44.2%, β blockers in 33.8%, and ACE inhibitors in 16.4%. The patients were subdivided into three groups according to the time of the initial visit to the clinic; initial visit during 1969-1979 (phase 1), 1980-1984 (phase 2) and 1985-1990 (phase 3). In the young, choice of β blockers and diuretics was most popular in phase 1. However, the choice of diuretics decreased in phase 2, and in phase 3 β blockers were used in 50.4%, Ca blockers in 43.2%, ACE inhibitors in 22.3% and diuretics in only 17.3%. In the elderly, diuretics were most popular followed by Ca blockers and β blockers in phase 1 and phase 2. In phase 3 Ca blockers were selected in 58.2% followed by both β blockers and ACE inhibitors in 28.4% then diuretics in 23.9%. These results indicate that the choice of antihypertensive drugs has, in brief, changed from β blockers or diuretics to β blockers or Ca blockers in the young and from diuretics or Ca blockers to Ca blockers in the elderly.