Klin Farmakol Farm. 2009;23(2):53-57

Risky combinations of cardiovascular drugs in elderly patients and factors increasing the probability of their occurrence

Martin Wawruch

Farmakologický ústav Lekárskej fakulty UK, Bratislava

Aim: The aim of the presented work was to analyse the prevalence of risky combinations of cardiovascular drugs. We assessed also patients

´ characteristics that increase the probability of their occurrence.

Methods: We enrolled 600 patients aged 65 years or more admitted to the Department of Internal Medicine of the Hospital in Povazska

Bystrica. To identify risky combinations of cardiovascular drugs the study of Vlahović-Palčevski et Bergman was applied. To define the

most important patient’s characteristics associated with the occurrence of risky combinations of cardiovascular medications, the binary

logistic regression model (SPSS for Windows, 15th version) was used.

Results: Risky combinations of cardiovascular drugs according to Vlahović-Palčevski and Bergman were found in 47 patients (7.8 %). The

combinations of angiotensin-converting enzyme (ACE) inhibitors with potassium sparing diuretics or with potassium supplements were

found to be the most common. Polypharmacy (odds ratio (OR) = 2.38; 95% confidence interval (CI) = 1.50–3.79), immobilization (OR =

1.87; 95% CI = 1.16–3.00) and atrial fibrillation (OR = 1.73; 95% CI = 1.13–2.64) were considered the most important patient’s characteristics

associated with prescription of risky combinations.

Conclusion: Elderly persons represent a vulnerable group regarding drug-drug interactions because of the common presence of polymorbidity

and polypharmacy. Present study is one of the studies that provide information on prescription of risky combinations of

cardiovascular drugs in elderly patients. The significant proportion of risky combinations observed in present study may be considered

rationally prescribed when laboratory markers and patients status is regularly monitored. Implementation of this topic within the framework

of continual medical education is needed.

Keywords: drug-drug interactions, angiotensin-converting enzyme inhibitors, non-steroidal anti-inflammatory drugs, warfarin, diuretics.

Published: July 1, 2009  Show citation