Cardiometabolic diseases and active aging - polypharmacy in control

ABSTRACT Objectives: To estimate the prevalence of cardiometabolic diseases and their association with polypharmacy in elderly people at the University of the Third Age (Portuguese acronym: UnATI). Methods: A cross-sectional, descriptive, analytical study with 121 elderly patients. The prevalence ratio, Pearson’s Chi-square test and Fisher’s exact test were used as measures of association. Results: At the mean age of 68.3, most elderly had at least one cardiometabolic disease (82.6%), of which hypertension was the most prevalent (71.1%), and consumed prescription drugs of continuous use (92.6%). Almost half of the elderly (48.2%) used combinations of drugs, which suggests a high cardiovascular risk. Polypharmacy due to prescription was observed in almost one-third (28.6%) of the sample, associated with the use of antihypertensives (p=0.004), antidiabetics (p=0.000) or lipid-lowering agents (p<0.000). Conclusions: Clinical guidelines recommend changes in lifestyle, but increased pharmacotherapy prevails in practice, which increases the risk of adverse events, especially in old age.

摘要 研究目的：评估葡萄牙老年大学（葡萄牙语缩写：UnATI）老年人群中心血管代谢疾病的患病率，及其与多重用药的相关性。方法：本研究为横断面描述性分析研究，共纳入121名老年受试者。采用患病率比、Pearson卡方检验及Fisher确切概率法作为关联分析统计指标。结果：受试者平均年龄为68.3岁，其中82.6%的老年人至少患有一种心血管代谢疾病，高血压为最常见高发类型，患病率达71.1%，且92.6%的受试者需长期服用处方药物。近半数（48.2%）老年人存在联合用药情况，提示其心血管风险较高。样本中约三分之一（28.6%）存在处方性多重用药现象，该现象与降压药（p=0.004）、降糖药（p=0.000）或调脂药（p<0.000）的使用显著相关。结论：临床指南推荐需调整生活方式，但临床实践中仍以强化药物治疗为主，这会增加不良事件发生风险，在老年人群中尤为显著。