Calcium antagonists in the elderly: A risk-benefit analysis

Drugs and Aging

Volumn 9, Issue 1, 1996, Pages 24-36

  Schwartz, Janice B ^a,b  

^a NORTHWESTERN UNIVERSITY   (United States)

^b NORTHWESTERN MEMORIAL HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AMLODIPINE; ANTIDEPRESSANT AGENT; ANTIRHEUMATIC AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM ANTAGONIST; CARDIOVASCULAR AGENT; CIMETIDINE; DIGOXIN; DIHYDROPYRIDINE DERIVATIVE; DILTIAZEM; DIURETIC AGENT; FELODIPINE; ISRADIPINE; LITHIUM; NICARDIPINE; NIFEDIPINE; NISOLDIPINE; NITRENDIPINE; QUINIDINE; RIFAMPICIN; VERAPAMIL;

AGED; ANGINA PECTORIS; BLOOD PRESSURE REGULATION; CLINICAL TRIAL; CONGESTIVE HEART FAILURE; CONSTIPATION; CORONARY ARTERY DISEASE; DRUG CLEARANCE; DRUG EFFICACY; DRUG SENSITIVITY; EDEMA; EXERCISE TOLERANCE; GAIT DISORDER; GINGIVA HYPERPLASIA; HEADACHE; HEART INFARCTION; HEART RATE; HEART SUPRAVENTRICULAR ARRHYTHMIA; HUMAN; HYPERTENSION; INTRAVENOUS DRUG ADMINISTRATION; MORBIDITY; MORTALITY; ORAL DRUG ADMINISTRATION; ORTHOSTATIC HYPOTENSION; PRIORITY JOURNAL; REVIEW; RISK BENEFIT ANALYSIS; STROKE; VERTIGO;

EID: 0030057125     PISSN: 1170229X     EISSN: None     Source Type: Journal    
DOI: 10.2165/00002512-199609010-00003     Document Type: Review

References (92)

1. Administration US FDA. Drug utilization in the U.S., 1989. 11th annual review. PB 1991; 91(198838)
2. Schwartz JB. Clinical pharmacology. In: Hazzard WR, Bierman EL, Blass JP, et al., editors. Principles of geriatric medicine and gerontology. 3rd ed. McGraw-Hill. Inc.: 259-76
3. Abernethy D, Schwartz J, Todd E, et al. Verapamil pharmacodynamics and disposition in young and elderly hypertensive patients. Ann Intern Med 1986; 105: 329-36
4. Abernethy D, Wainer I, Longstreth J, et al. Stereoselective verapamil disposition and dynamics in aging during racemic verapamil administration. J Pharmacol Exp Ther 1993; 266: 904-11
5. Ahmed J, Meredith P, Elliott H. The influence of age on the pharmacokinetics of verapamil. Pharmacol Res 1991; 24: 227-33
6. Schwartz J. Aging alters verapamil elimination and dynamics: single dose and steady-state responses. J Pharmacol Exp Ther 1990; 255: 364-73
7. Schwartz J, Troconiz I, Verotta D, et al. Aging effects on Stereoselective pharmacokinetics and pharmacodynamics of verapamil. J Pharmacol Exp Ther 1993; 265: 690-8
8. Schwartz J, Capili H, Daugherty J. Aging of women alters S-verapamil pharmacokinetics and pharmacodynamics. Clin Pharmacol Ther 1994; 55: 509-17
9. Robertson D, Waller D, Renwick A, et al. Age-related changes in the pharmacokinetics and pharmacodynamics of nifedipine. Br J Clin Pharmacol 1988; 25: 297-305
10. Abernethy D, Gutkowska J, Winterbottom L. Effects of amlodipine, a long-acting dihydropyridine calcium antagonist in aging hypertension: pharmacodynamics in relation to disposition. Clin Pharmacol Ther 1990; 48: 76-86
11. Abernethy D, Gutkowska J, Lambert M. Amlodipine in elderly hypertensive patients: pharmacokinetics and pharmacodynamics. J Cardiovasc Pharmacol 1988; 12 (Suppl.): S67-S71
12. Laplanche R, Feril B, Nuesch E, et al. Exploratory analysis of population pharmacokinetic data from clinical trials with application to isradipine. Clin Pharmacol Ther 1991; 50: 39-54
13. Wade J, Sambol N. Felodipine population dose-response and concentration-response relationships in patients with essential hypertension. Clin Pharmacol Ther 1995; 57 (5): 569-81
14. Lettieri J, Krol G, Yeh S, et al. The effects of age and race on nitrendipine pharmacokinetics and pharmacodynamics. J Cardiovasc Pharmacol 1988; 12 (4): S129-S132
15. Blychert E, Edgar B, Elmfeldt D, et al. A population study of the pharmacokinetics of felodipine. Br J Clin Pharmacol 1991; 31: 15-24
16. Baksi A, Edwards J, Ahr G. A comparison of the pharmacokinetics of nisoldipine in elderly and young subjects. Br J Clin Pharmacol 1991; 31: 367-70
17. Forette F, Bellet M, Henry J, et al. Effect of nicardipine in elderly hypertensive patients. Br J Clin Pharmacol 1985; 20 Suppl. 1: 125S-129S
18. Van Harten J, Burggraaf J, Ligthart G, et al. Single- and multiple-dose nisoldipine kinetics and effects in the young, the middle-aged, and the elderly. Clin Pharmacol Ther 1989; 45: 600-7
19. Forette F, McClaren J, Hervy M, et al. Nicardipine in elderly patients with hypertension: a review of experience in France. Am Heart J 1989; 117: 256-61
20. Montamat S, Abernethy D. Calcium antagonists in geriatric patients: diltiazem in elderly persons with hypertension. Clin Pharmacol Ther 1989; 45: 682-91
21. Schwartz J, Abernethy D. Responses to intravenous and oral diltiazem in elderly and younger patients with systemic hypertension. Am J Cardiol 1987; 59: 1111-7
22. Watkins P, Turgeon D, Saenger P. et al. Comparison of urinary 6-b-cortisol and the erythromycin breath test as measures of hepatic P450IIIA (CYP3A) activity. Clin Pharmacol Ther 1992; 52: 265-73
23. Ryan D, Levin W. Purification and characterization of hepatic microsomal cytochrome P-450. Pharmacol Ther 1990; 45: 153-239
24. Kroemer H, Gautier J, Beaune P, et al. Identification of P450 enzymes involved in metabolism of verapamil in humans. Arch Pharmacol 1993; 348: 332-7
25. Hunt C, Westerkam W, Stave G. Effect of age and gender on the activity of human hepatic CYP3A. Biochem Pharmacol 1992; 44: 275-83
26. Hunt C, Westerkam W, Stave G, et al. Hepatic cytochrome P-4503A (CYP3A) activity in the elderly. Mech Ageing Dev 1992; 64: 189-99
27. Geokas MC, Haverback BJ. The aging gastrointestinal tract. Am J Surg 1969; 117: 881-92
28. Ahmed J, Elliott H, Meredith P, et al. Low-dose verapamil in middle-aged and elderly patients with angina pectoris: no evidence of increased susceptibility to the cardiac effects. Cardiovasc Drugs Ther 1992; 6: 153-8
29. Elkik F, Claudel S, Carcone B, et al. Demographic factors and the antihypertensive effect of diltiazem. J Cardiovasc Pharmacol 1991; 17 (5): 685-91
30. Porchet H, Loew F, Gauthey L, et al. Serum concentration-effect relationship of (±)-nicardipine and nifedipine in elderly hypertensive patients. Eur J Clin Pharmacol 1992; 43: 551-3
31. Abernethy D. An overview of the pharmacokinetics and pharmacodynamics of amlodipine in elderly persons with systemic hypertension. Am J Cardiol 1994; 73: 10A-17A
32. Bravo EL, Krakoff LR, Tuck ML, et al. Antihypertensive effectiveness of nifedipine gastrointestinal therapeutic system in the elderly: the Modern Approach to the Treatment of Hypertension (MATH) Study Group. Am J Hypertens 1990 Dec: 3 (12 Pt 2): 326S-32S
33. Scott M, Castleden C, Adam H, et al. The effect of ageing on the disposition of nifedipine and atenolol. Br J Clin Pharmacol 1988; 25: 289-96
34. Lakatta E. Cardiovascular regulatory mechanisms in advanced age. Physiol Rev 1993; 73 (2): 413-67
35. Somberg J, Achari R, Laddu A. Terazosin: pharmacokinetics and the effect of age and dose on the incidence of adverse events. Am Heart J 1991; 122 (3): 901-5
36. Aronow W, Ahn C. Postprandial hypotension in 499 elderlypersons in a long-term health care facility. J Am Geriatr Soc 1994; 42: 930-2
37. Schneider J, Mion L, Frengley J. Adverse drug reactions in an elderly outpatient population. Am J Hosp Pharm 1992; 49: 90-6
38. Walker J, Wynne H. Review, the frequency and severity of adverse drug reactions in elderly people. Age Ageing 1994; 23: 255-9
39. Cumming R, Miller J, Kelsey J, et al. Medications and multiple falls in elderly people: the St Louis OASIS study. Age Ageing 1991; 20 (6): 455-61
40. Schwartz J, Caputo G, Abbot J. Early experience with dobutamine stress testing and cardiac cinetomographic imaging in the elderly: antianginal effects of nifedipine-GITS. J Am Geriatr Soc 1993; 41: 967-74
41. Physicians desk reference. 49th ed. Montvale. N.J.: Medical Economics Data, 1995
42. Schwartz J, Nielsen A, Griffin J. Concentration-dependent enhancement of junctional pacemaker activity by verapamil in man. Circulation 1985; 71: 450-7
43. Schwartz J, Keefe D, Kirsten E, et al. Acute and chronic pharmacodynamic interaction of verapamil and digoxin and atrial fibrillation. Circulation 1982; 65: 1163-70
44. Gurwitz JH, Avorn J. The ambiguous relation between aging and adverse drug reactions. Ann Intern Med 1991; 114: 956-66
45. Carbonin P, Pahor M, Bernabei R, et al. Is age an independent risk factor of adverse drug reactions in hospitalized medical patients? J Am Geriatr Soc 1991; 39: 1093-9
46. Brody JA, Brock DB, Williams TF. Trends in the health of the elderly population. Annu Rev Public Health 1987; 8: 211-34
47. Schwartz JB, Keefe DL, Kirsten EB, et al. Acute and chronic pharmacodynamic interaction of verapamil and digoxin in atrial fibrillation. Circulation 1982; 65: 1163-70
48. Belz G, Doering W, Munkes R, et al. Effects of various calcium antagonists on blood level and renal clearance of digoxin. Circulation 1980; 64: 24
49. Belz G, Doering W, Munkes R, et al. Interaction between digoxin and calcium antagonists and antiarrhythmic drugs. Clin Pharmacol Ther 1983; 33: 410-7
50. Schwartz J, Migliore P. Effect of nifedipine on serum digoxin concentration and renal digoxin clearance. Clin Pharmacol Ther 1984; 36 (1): 19-24
51. Schwartz J, Raizner A, Akers S. The effect of nifedipine on serum digoxin concentrations in patients. Am Heart J 1984; 107: 669-73
52. Maisel A, Motulsky H, Insel P. Hypotension after quinidine plus verapamil: possible additive competition at alpha-adrenergic receptors. N Engl J Med 1985; 312 (3): 167-70
53. Price WA, Shalley JE. Lithium-verapamil toxicity in the elderly [letter]. J Am Geriatr Soc 1987; 35: 177-9
54. Somogyi A, Gugler R. Drug interactions with cimetidine. Clin Pharmacokinet 1982; 7: 23-41
55. Schwartz J, Upton R, Lin E, et al. Effect of cimetidine or ranitidine administration on nifedipine pharmacokinetics and pharmacodynamics. Clin Pharmacol Ther 1988; 43: 673-80
56. Abernethy D, Schwartz J, Todd E. Lack of interaction between verapamil and cimetidine. Clin Pharmacol Ther 1985; 38: 342-9
57. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991 Jun 26; 265: 3255-64
58. Hulley S, Furberg C, Gurland B, et al. Systolic hypertension in the elderly program (SHEP): antihypertensive efficacy of chlorthalidone. Am J Cardiol 1985; 56: 913-20
59. Hall W. Systolic hypertension in the elderly program: implications for the management of older hypertensive patients. Am J Geriatr Cardiol 1992; Jul/Aug: 15-27
60. Bird A, Blizard R, Mann A. Treating hypertension in the older person: an evaluation of the association of blood pressure level and its reduction with cognitive performance. J Hypertens 1990; 8: 147-52
61. Fletcher A, Amery A, Birkenhager W, et al. Risks and benefits in the trial of the European working party on high blood pressure in the elderly. J Hypertens 1991; 9: 225-30
62. Coope J, Warrender T. Randomised trial of treatment of hypertension in elderly patients in primary care. BMJ 1986; 293: 1145-52
63. Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the hypertension detection and follow up program: I. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 1979 Dec 7; 242: 2562-71
64. Prisant L, Carr A. Overview of the findings of the European party on high blood pressure in the elderly. Geriatr Med Today 1990; 9: 35-8
65. Wikstrand J, Warnold I, Olsson G, et al. Primary prevention with metoprolol in patients with hypertension: mortality results from the MAPHY study. JAMA 1988; 259: 1976-82
66. Johannesson M, Jonsson B. A review of cost-effectiveness analyses of hypertension treatment. PharmacoEconomics 1992; 1: 250-64
67. Drugs for hypertension. Med Lett Drugs Ther 1995; 37 (949). 45-50
68. Hilleman D, Mohiuddin S, Lucas J, et al. Cost-minimization analysis of initial antihypertensive therapy in patients with mild-to-moderate essential diastolic hypertension. Clin Ther 1994; 16 (1): 88-102
69. Edelson J, Weinstein M, Tostenson A. Long-term cost-effectiveness of various initial monotherapies for mild to moderate hypertension. JAMA 1990; 263: 408-13
70. Psaty B, Koepsell T, Yanez N, et al. Temporal patterns of antihypertensive medication use among older adults, 1989 through 1992. JAMA 1995; 273 (18): 1436-8
71. McVeigh G, Flack J, Grimm R. Goals of antihypertensive therapy. Drugs 1995; 49(2): 161-75
72. McClellan K. Unexpected results from MIDAS in atherosclerosis. Inpharma 1994; 932: 4
73. Furberg C. Final results of the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS). International Society of Hypertension Meeting: 1994; Melbourne
74. Gong L, Zwang W, Zhu Y. Shanghai trial of nifedipine in the elderly [abstract]. Seventh European meeting on hypertension: 1995 Jun 12: Milan
75. Psaty B, Heckbert S, Koepsell T, et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA 1995; 274 (8): 620-5
76. Furberg C, Psaty B, Meyer J. Nifedipine dose-related increase in mortality in patients with coronary heart disease. Circulation 1995; 92 (5): 1326-31
77. Pahor M, Guralnik J, Corti M, et al. Long-term survival and use of antihypertensive medications in older persons. J Am Geriatr Soc 1995; 43: 1191-7
78. Opie L, Messerli F. Nifedipine and mortality: grave defects in the dossier. Circulation 1995; 92: 1068-73
79. Parmley W, Nesto R, Singh B, et al. Attenuation of the circadian patterns of myocardial ischemia with nifedipine GITS in patients with chronic stable angina. J Am Coll Cardiol 1992; 19 (7): 1380-9
80. Vaage-Nilsen M, Rasmussen V, Hansen J, et al. Effect of verapamil on arrhythmias and heart rate during 16 months following an acute myocardial infarction. Cardiovasc Drugs Ther 1994; 8 (1): 147-51
81. Vaage-Nilsen M, Hansen J, Mellemgaard K, et al. Effect of verapamil on the prognosis of patients with early postinfarction electrical or mechanical complications. Im J Cardiol 1995; 48 (3): 255-8
82. Gheorgiade M, Weiner D, Chakko S, et al. Monotherapy of stable angina with nicardipine hydrochloride: double-blind, placebo-controlled, randomized study. Eur Heart J 1989; 10: 695-701
83. Scheidt S, Le Winter M, Hermanovich J, et al. Efficacy and safety of nicardipine for chronic, stable angina pectoris: a multicenter randomized trial. Am J Cardiol 1986; 58: 715-21
84. Yusuf S, Held P, Furberg C. Update of effects of calcium antagonists in myocardial infarction or angina in light of the second Danish Verapamil Infarction Trial (DAVIT-II). Am J Cardiol 1991; 67: 1295-7
85. Hansen J. Review of postinfarct treatment with verapamil: combined experience of early and late intervention studies with verapamil in patients with acute myocardial infarction. Cardiovasc Drugs Ther 1994; 8 Suppl. (3): 543-7
86. Jespersen C. The effect of verapamil on major events in patients with impaired cardiac function recovering from acute myocardial infarction. Eur Heart J 1993; 14 (4): 540-5
87. Jespersen C. Role of ischemia in postinfarction heart failure: hypothetical considerations based on use of verapamil in the DAVIT II Study. Danish Study Group on Verapamil in Myocardial Infarction. Cardiovasc Drugs Ther 1994; 8 (6): 823-8
88. The Multicenter Diltiazem Postinfarction Trial Research Group. The effect of diltiazem on mortality and reinfarction after myocardial infarction. N Engl J Med 1988; 319: 385-92
89. Held P, Yusuf S. Impact of calcium channel blockers on mortality in survivors of acute myocardial infarction. In: Singh B, Wellens H, Hiraoka M, editors. Electropharmacological control of cardiac arrhythmias. Mount Kisco, NY: Futura Publishing, Co. Inc., 1994; 399-411
90. Fisher M, Grotta J. New uses for calcium channel blockers: therapeutic implications. Drugs 1993; 46 (6): 961-75
91. Lull F, Haller H. Calcium channel blockers in current medical practice: an update for 1993. Clin Exp Hypertens 1993; 15 (6): 1263-76
92. Kaste M, Fogelholm R, Erila T, et al. A randomized, double-blind, placebo-controlled trial of nimodipine in acute ischemic hemispheric stroke. Stroke 1994; 25 (7): 1348-53