OBJECTIVE: To assess the influence vulnerability and severity of @entity65 ( @entity65 ), on prescription rates of secondary cardiovascular preventive drugs in old age. DESIGN: Population-based observational study within the ISCOPE study. SETTING: General practices in the Netherlands. SUBJECTS: A total of 1350 @entity1 with a history of @entity65 (median age 81 years, 50% female). MAIN OUTCOME MEASURES: One-year prescription rates of lipid-lowering drugs and antithrombotics were obtained from the electronic medical records of 46 general practitioners (GPs). Prescription of both drugs for   >=    270 days per year was considered optimal. GPs made a judgement of vulnerability. Severity of @entity65 was expressed as major ( @entity583 , @entity64 , or arterial surgery) versus minor ( @entity951 , transient @entity2142 , or @entity613 ). RESULTS: GPs considered 411 (30%) @entity1 to be vulnerable and 619 (55%) @entity1 had major @entity65 . Optimal treatment was prescribed to 680 (50%) @entity1 , whereas 370 (27%) received an antithrombotic drug only, 53 (4%) a lipid-lowering drug only, and 247 (18%) received neither. Optimal treatment was lower in @entity1 aged   >=    85 years (OR 0.37 [95% CI 0.29-0.48]), in females (OR 0.63 [0.50-0.78]), in vulnerable @entity1 (OR 0.79 [0.62-0.99]) and in @entity1 with minor @entity65 (OR 0.65 [0.53-0.81]). Multivariate ORs remained similar whereas vulnerability lost its significance (OR 0.88 [0.69-1.1]). CONCLUSION: In old age, GPs' judgement of vulnerability is not independently associated with lower treatment rates of both lipid-lowering drugs and antithrombotics, whereas a history of minor @entity65 is. Individual proactive re-evaluation of preventive treatment in older (female) @entity1 , especially those with a history of minor @entity65 , is recommended. Key points Prescriptions of lipid-lowering drugs and antithrombotics in secondary cardiovascular prevention tend to decline with age. In this study with median age 81 years, 50% of @entity1 received optimal treatment with both lipid-lowering drugs and antithrombotics. GPs' judgement of vulnerability was not independently associated with optimal treatment. A history of less severe @entity65 was independently associated with lower prescription rates of lipid-lowering drugs and antithrombotics. Proactive individual re-evaluation of cardiovascular preventive treatment in older (female) @entity1 , especially @entity1 with less severe @entity65 , is recommended.

Drug prescription rates in secondary cardiovascular prevention in old age: Do vulnerability and severity of the history of XXXX matter?

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'persons'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity951 :: ('MESH:D000787', 'Disease') :: ['angina'] @entity613 :: ('MESH:D007383', 'Disease') :: ['claudication'] @entity2142 :: ('MESH:D006461', 'Disease') :: ['ischaemic attack'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity65 :: ('MESH:D002318', 'Disease') :: ['CVD', 'cardiovascular disease']
@entity65 :: (MESH:D002318,Disease) :: ['cardiovascular disease']
