Safe Medication Use for Older Adults with CVD

Older adults often have reduced renal and hepatic function, altered drug distribution, increased sensitivity to medications, frailty, and polypharmacy, all of which increase the risk of adverse drug reactions.

Accurate medication reconciliation is the most important first step, especially during transitions of care such as hospital admission and discharge.

Many older adults with established cardiovascular disease continue to benefit from statins for secondary prevention, but the decision should consider frailty, life expectancy, adverse effects, and patient preferences.

Not necessarily. In many patients with atrial fibrillation, the stroke-prevention benefit of anticoagulation still outweighs the bleeding risk, although decisions must be individualized.

It means initiating medications at a lower dose than usual when appropriate and increasing the dose gradually while monitoring for efficacy and adverse effects.

At minimum annually, and more frequently after hospitalization, significant health changes, medication adjustments, or the development of frailty or cognitive impairment.