Disparities in combination drug therapy use in older adults with coronary heart disease: a cross-sectional time-series in a nationally representative US sample.
Disparities in combination drug therapy use in older adults with coronary heart disease: a cross-sectional time-series in a nationally representative US sample.
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DOI：
10.2165/11532150-000000000-00000
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发表时间：
2010-02-01
期刊：
影响因子：
2.8
通讯作者：
Goldberg RJ
中科院分区：
文献类型：
--
作者：
Tjia J;Briesacher B;Xie D;Fu J;Goldberg RJ
尽管有证据表明，有效的联合药物治疗冠心病（CHD）的二级预防，老年人仍然治疗不足。描述老年CHD患者采用联合心脏药物治疗（β受体阻滞剂、血管紧张素转换酶抑制剂[ACE]或血管紧张素II受体阻滞剂[ARB]和降脂药）的时间趋势（1992-2003年），并确定与不使用联合治疗相关的因素。横截面时间序列。年龄≥ 65岁的CHD成人的全国代表性样本（未加权n= 6 331; 1992-2003年医疗保险当前受益调查中纳入的加权n= 2010万）（无药物或使用β受体阻滞剂、ACE/ARB的单一药物治疗，或降脂药）与联合治疗（≥ 2种心脏药物）相比，用于CHD二级预防。在研究期间，老年冠心病患者联合药物治疗的使用增加了9倍（1992年为6%，2003年为54%）。校正分析表明，次优药物治疗与高龄独立相关（相对风险[RR] 1.18 [95%置信区间：1.14-1.23]），≥85岁vs 65-74岁;黑人（RR 1.05 [95% CI：1.01-1.10]）或西班牙裔（RR 1.12 [95% CI：1.06-1.21]）vs非西班牙裔白色人。在过去的十年中，老年人中用于二级冠心病预防的联合药物治疗增加，但改善并不一致。年龄最大的非西班牙裔黑人和西班牙裔人在采用最佳药物治疗以改善其冠心病长期预后方面进展缓慢。
Despite evidence of effective combination drug therapy for secondary prevention of coronary heart disease (CHD), older adults remain undertreated. To describe time trends (1992–2003) in the adoption of combination cardiac drug therapies (beta blockers, angiotensin-converting enzyme inhibitors [ACE] or angiotensin II receptor blockers [ARB], and lipid-lowering agents) among older adults with CHD and to identify factors associated with not using combination therapy. Cross-sectional time-series. Nationally representative sample of adults aged ≥ 65 years with CHD (unweighted n=6,331; weighted n=20.1 million) included in the 1992–2003 Medicare Current Beneficiary Survey The outcome measure is low-intensity cardiac pharmacotherapy (no drug or single drug therapy with beta-blockers, ACE/ARBs, or lipid-lowering agents) compared to combination therapy (≥ 2 cardiac drugs) for secondary CHD prevention. Use of combination drug therapy in older adults with CHD increased 9-fold during the study period (6% in 1992 to 54% in 2003). Adjusted analyses demonstrate that suboptimal drug therapy was independently associated with advanced age (relative risk [RR] 1.18 [95% confidence interval: 1.14–1.23]) for persons ≥85 years vs 65–74 years; being black (RR 1.05 [95% CI: 1.01–1.10]) or Hispanic (RR 1.12 [95% CI: 1.06–1.21]) vs being non-Hispanic white. Combination drug therapy use for secondary CHD prevention increased in older adults over the last decade, but improvements were not uniform. The oldest-old, non-Hispanic blacks and Hispanics experienced slower adoption of optimal medical therapy to improve their long-term prognosis for CHD.
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影响因子：
120.7
作者：
ELLERBECK, EF;JENCKS, SF;VOGEL, RA
通讯作者：
VOGEL, RA
DOI：
10.1034/j.1600-0579.2003.00211.x
发表时间：
2003-05-01
影响因子：
6.3
作者：
Brown, AF;Gross, AG;Mangione, CM
通讯作者：
Mangione, CM
影响因子：
4.8
作者：
Spencer, FA;Lessard, D;Goldberg, RJ
通讯作者：
Goldberg, RJ
影响因子：
37.8
作者：
Smith, Sidney C., Jr.;Allen, Jerilyn;Taubert, Kathryn A.
通讯作者：
Taubert, Kathryn A.
影响因子：
--
作者：
Goldberg, Robert J.;Spencer, Frederick A.;Gore, Joel M.
通讯作者：
Gore, Joel M.