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Association between Polypharmacy and Cardiovascular Autonomic Function among Elderly Patients in an Urban Municipality Area of Kolkata, India: A Record-Based Cross-Sectional Study

Authors :
Shambo Samrat Samajdar
Saibal Das
Sougata Sarkar
Shatavisa Mukherjee
Ashish Pathak
Cecilia Stålsby Lundborg
Indranil Saha
Santanu Kumar Tripathi
Jyotirmoy Pal
Nandini Chatterjee
Shashank R Joshi
Source :
Geriatrics, Vol 7, Iss 6, p 136 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

We assessed the association between polypharmacy and cardiovascular autonomic function among community-dwelling elderly patients having chronic diseases. Three hundred and twenty-one patients from an urban municipality area of Kolkata, India were studied in August 2022. The anticholinergic burden and cardiac autonomic function (Valsalva ratio, orthostatic hypotension, change in diastolic blood pressure after an isometric exercise, and heart rate variability during expiration and inspiration) were evaluated. Binary logistic regression analysis was performed to find out the association of polypharmacy and total anticholinergic burden with cardiac autonomic neuropathy. A total of 305 patients (age, 68.9 ± 3.4; 65.9% male) were included. Of these patients, 81 (26.6%) were on polypharmacy. Out of these 81 patients, 42 patients were on ninety-eight potential inappropriate medications. The anticholinergic burden and the proportion of patients with cardiac autonomic neuropathy were significantly higher among patients who were on polypharmacy than those who were not (8.1 ± 2.3 vs. 2.3 ± 0.9; p = 0.03 and 56.8% vs. 44.6%; p = 0.01). The presence of polypharmacy and a total anticholinergic burden of > 3 was significantly associated with cardiac autonomic neuropathy (aOR, 2.66; 95% CI, 0.91–3.98 and aOR, 2.51; 95% CI, 0.99–3.52, respectively). Thus, polypharmacy was significantly associated with cardiac autonomic neuropathy among community-dwelling elderly patients.

Details

Language :
English
ISSN :
23083417
Volume :
7
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Geriatrics
Publication Type :
Academic Journal
Accession number :
edsdoj.fd4ffbaa74ec4ca28a044024f6210b31
Document Type :
article
Full Text :
https://doi.org/10.3390/geriatrics7060136