Pattern of Use of β-Blockers in Older Patients with Stable Coronary Artery Disease.

Background: Several drugs, including β-blockers (β-adrenoceptor antagonists), are largely under-utilized in older patients with cardiovascular disease. Objectives: The aims of this study were to evaluate whether older patients (aged ⩽ 65 years) with coronary artery disease (CAD) have a different pattern of use of n-blockers than younger adult patients (aged < 65 years) and whether gender differences or other clinical variables may influence the use of these drugs. Methods: Over 6 months, 2226 outpatients with stable CAD were enrolled in an observational, cross-sectional, multicentre survey. Of these, 1416 patients aged ⩽ 65 years were grouped into four subgroups according to age. Predictors of β-blocker use were determined using logistic regression analyses. Comparisons between younger adults and older patients were conducted using Student's t-tests and chi-squared (x2) tests. Results: Up to 47% of older patients were not receiving β-blockers, and this percentage progressively increased with age, with the oldest patients showing the lowest rate of utilization. No gender difference in the pattern of use of β-blockers was noted. The prescription of β-blockers was higher in patients with heart failure (HF) than in patients without HF. The presence of HF abolished the decrease inβ-blocker use with age. Logistic regression analysis confirmed that lower age and severe HF were independent predictors of n-blocker use in older people. Conclusions: Age appears to be a key factor in the under-prescription of p-blockers in CAD outpatients. Despite the recommendations, and the efforts of cardiologists, the use of β-blockers in the elderly is still limited, possibly because of practical constraints such as adverse effects and co-morbidity. In patients with HF, age is less important in determining the use of β-blockers. [ABSTRACT FROM AUTHOR]