Older people cardiovascular disease

ACE drinks, containing beta-carotene (vitamin A precursor) and vitamins C and E. These materials are antioxidants and there is evidence that eliminating free radicals in the body will protect against cancer and cardiovascular diseases, particularly in older people. Suggested levels to... 

Levy D. Proteinuria as a risk factor for cardiovascular disease and mortality in older people A prospective study. Am J Med 2000 109 1-8. 

People at greatest risk for nephrotoxicity have chrmiic kidney disease (CKD), hepatic disease with ascites, decompensated cOTigestive heart failure, intravascular volume depletion, or systemic lupus erythematosus (Perazella 2005). Additional risk factors include atherosclerotic cardiovascular disease and concurrent diuretic therapy. The elderly are also at higher risk due to interaction of prevalent medical problems, multiple drug therapies, and reduced renal hemodynamics. NS AID use in patients older than 65 years may increase the risk of AKI by up to 58% (Griffin et al. 2000). Combined NSAID or COX-2 inhibitor and ACEI or ARB therapy is also a concern and should be avoided in high risk patients. 

The best overall evidence of the safety of diuretics in old people comes from the large-scale outcome trials in hypertensive patients (11,13,15,17,18). These studies in over 10000 subjects aged over 60 years showed clearly that thiazide-based treatment reduces the risk of stroke, coronary heart disease events, and cardiovascular events in older hypertensive patients. A meta-analysis (163) of randomized trials lasting at least 1 year and involving 16164 individuals aged at least 60 years showed that diuretics were superior to beta-blockers with regard to all endpoints (stroke, coronary heart disease events, cardiovascular mortality, and all-cause mortality). The beneficial effects noted in these trials should dispel any doubts about the safety and efficacy of diuretics in old people. 

As with cardiac and blood disorders, respiratory disease is relatively common in many older patients. However, there are common respiratory disorders that affect younger people as well. Although there are probably not as many diseases of the respiratory system as there are of the cardiovascular system, there are still a number of important groups of drugs that are used to treat respiratory disorders and their use can be life saving. 

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