Risks of polypragmasia in elderly patients with cardiovascular diseases
DOI: 10.32364/2587-6821-2025-9-1-10
Longer life expectancy led to an increased number of elderly people living with two or more chronic diseases. The combination of chronic diseases causes polypragmasia (i. e., a need to take five or more drug products per day). Ageing is accompanied by cardiovascular alterations affecting pharmacokinetics and pharmacodynamics of drug products. As cardiovascular diseases (CVD) are the most common conditions among the elderly, cardiovascular agents are the most popular in the population. Polypragmasia in the elderly with CVD increases a risk of adverse drug reactions which, in turn, can lead to increased mortality and health care costs. Typically, clinical guidelines are focused on a single disease. Therefore, they do not always address medical care for patients with polymorbidity and polypragmasia. The review considers the key issues faced by physicians in real clinical practice when prescribing treatment to elderly patients with CVD, polymorbidity and polypragmasia. Basic ways to mitigate the risk of adverse drug reactions in real clinical practice are reported.
Keywords: cardiovascular diseases, polypragmasia, polymorbidity, drug-drug interaction, ageing, elderly, adverse drug reaction.
For citation: Dolgusheva Yu.A., Efremova Yu.E., Kudrina V.G., Agapova O.Yu., Mironov N.Yu., Bogdanova V.O. Risks of polypragmasia in elderly patients with cardiovascular diseases. Russian Medical Inquiry. 2025;9(1):77–84 (in Russ.). DOI: 10.32364/2587-6821- 2025-9-1-10
ABOUT THE AUTHORS:
Yulia A. Dolgusheva — C. Sc. (Med.), Scientific Officer, Scientific and Organizational Department, Acad. E.I. Chazov National Medical Research Center of Cardiology; 15A, Academician Chazov str., Moscow, 121552, Russian Federation; Senior Scientific Officer, Medical Informatics Scientific Laboratory, Scientific Research Association, Plekhanov Russian University of Economics; 36, Stremyannyilane, Moscow, 117997, Russian Federation; ORCID iD 0000-0002-9326-2071
Yulia E. Efremova — C. Sc. (Med.), Senior Scientific Officer, Scientific and Organizational Department, Acad. E.I. Chazov National Medical Research Center of Cardiology; 15A, Academician Chazov str., Moscow, 121552, Russian Federation; ORCID iD 0000-0001-8674-9669
Valentina G. Kudrina — Dr. Sc. (Med.), Professor, Head of the Department of Medical Statistics and Digital Healthcare, Russian Medical Academy of Continuous Professional Education; 2/1, Barrikadnaya str., Moscow, 125993, Russian Federation; Chief Scientific Officer, Scientific Research Association, Plekhanov Russian University of Economics; 36, Stremyannyi lane, Moscow, 117997, Russian Federation; ORCID iD 0000-0002-4329-1165
Olga Yu. Agapova — C. Sc. (Med.), Assistant Professor of the Department of Faculty Therapy and Occupational Diseases, N.A. Semashko Scientific Educational Institute of Clinical Medicine, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0001-9480-8999
Nikolai Yu. Mironov — C. Sc. (Med.), Senior Scientific Officer, Department of Clinical Electrophysiology and X-ray Surgical Methods for Cardiac Arrhythmia Treatment, Acad. E.I. Chazov National Medical Research Center of Cardiolo-
gy; 15A, Academician Chazov str., Moscow, 121552, Russian Federation; Senior Scientific Officer, Medical Informatics Scientific Laboratory, Plekhanov Russian University of Economics; 36, Stremyannyi lane, Moscow, 117997, Russian Federation; ORCID iD 0000-0002-6086-6784
Valeriya O. Bogdanova — C. Sc. (Med.), Assistant Professor of the Department of Healthcare Organization and Public Health with Healthcare Technology Assessment Course, Russian Medical Academy of Continuous Professional Education; 2/1, Barrikadnaya str., Moscow, 125993, Russian Federation; Clinical Pharmacologist, National Medical Research Center for Endocrinology; 11, Dmitriy Ul'yanov str., Moscow, 117036, Russian Federation; Senior Scientific Officer, Medical Informatics Scientific Laboratory, Plekhanov Russian University of Economics; 36, Stremyannyi lane, Moscow, 117997, Russian Federation; ORCID iD 0000-0001-7762-7854
Contact information: Yulia A. Dolgusheva, e-mail: dol.85@mail.ru
Financial Disclosure: the study was funded by the Russian Science Foundation (Grant No. 23-75-30012).
Conflict of interest: no conflict of interest.
Received 10.06.2024.
Revised 04.07.2024.
Accepted 29.07.2024.
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