{"id":16437,"date":"2014-02-28T14:29:20","date_gmt":"2014-02-28T19:29:20","guid":{"rendered":"http:\/\/therapytoronto.ca\/news\/?p=16437"},"modified":"2014-03-03T01:54:11","modified_gmt":"2014-03-03T06:54:11","slug":"over-80s-often-over-treated-for-stroke-prevention","status":"publish","type":"post","link":"https:\/\/therapytoronto.ca\/news\/2014\/02\/over-80s-often-over-treated-for-stroke-prevention\/","title":{"rendered":"Over-80s often over-treated for stroke prevention"},"content":{"rendered":"

From the BMJ<\/em>–British Medical Journal<\/em> media release:<\/p>\n

\"senior_medication\"<\/a>People in their 80s are often prescribed drugs to ward off a stroke when the risk of a stroke is not that high and the drugs have other side effects<\/strong>, finds a perspective published online in Evidence Based Medicine<\/em>.<\/p>\n

People in this age group are being “over-treated,” and doctors need to actively rethink their priorities and beliefs about stroke prevention<\/strong>, argues Dr Kit Byatt of the Department of Geriatric Medicine, The County Hospital in Hereford, UK.<\/p>\n

Statins and antihypertensive drugs were the most commonly prescribed cardiovascular drugs in the UK in 2006. And they are widely prescribed to patients in their 80s to ward off stroke.<\/p>\n

This is despite the fact that the research shows that, by this age, high blood pressure<\/a> is not a key contributory risk factor<\/strong>, and high cholesterol<\/a> has little effect on stroke risk, overall, says Dr Byatt.<\/p>\n

He points out that the largest trials of antihypertensive therapy and statins for people in this age group have shown only a marginal reduction in stroke and very modest reductions in other cardiovascular events<\/strong>.<\/p>\n

Older patients have diverse views on the relative importance of stroke and death as end points, which differ from clinicians’ beliefs, he argues.<\/p>\n

The evidence suggests that statins and antihypertensive drugs are greatly over-prescribed in the healthy elderly and are mostly irrelevant in the frail elderly.<\/p>\n

Most older patients would probably reject the modest potential benefit conferred by these medicines<\/strong>, in favour of taking fewer drugs every day and not having to put up with their possible side-effects, he suggests.<\/p>\n

“The data strongly suggest that we are over-treating many healthy patients aged 80+ regarding stroke prevention,” he concludes.<\/p>\n

And he questions whether these drugs should ever be used in frail older patients with several underlying conditions<\/p>\n

“Should we ever use these medications in frail older patients with multi-morbidity?<\/strong> We need actively to rethink our priorities and beliefs about stroke prevention, actively informing and involving the views of the key person, the patient,” he insists.<\/p><\/blockquote>\n

“Overenthusiastic stroke risk factor modification in the over-80s: Are we being disingenuous to ourselves, and to our oldest patients?” Online First doi:10.1136\/eb-2013-101646<\/p>\n","protected":false},"excerpt":{"rendered":"

From the BMJ–British Medical Journal media release: People in their 80s are often prescribed drugs to ward off a stroke when the risk of a stroke is not that high… Read more »<\/a><\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[321,10,344],"tags":[],"_links":{"self":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/16437"}],"collection":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/comments?post=16437"}],"version-history":[{"count":1,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/16437\/revisions"}],"predecessor-version":[{"id":16441,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/16437\/revisions\/16441"}],"wp:attachment":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/media?parent=16437"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/categories?post=16437"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/tags?post=16437"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}