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Abstract
Background: An age bias may exist in the prescription of important secondary-preventive therapies in the elderly.
Objective: To evaluate patterns of drug prescription for cardiovascular prevention in the very elderly following hospitalization for an acute ischemic stroke or TIA.
Methods: The authors compared subjects ages ≥80 with those <80 in the California Acute Stroke Prototype Registry to evaluate the impact of age on receipt of secondary-prevention medications at the time of hospital discharge. Prespecified secondary-prevention drug classes studied were antithrombotics, lipid-lowering agents, and antihypertensives.
Results: Overall, there were 260 patients age ≥80 and 534 age <80 admitted with stroke or TIA during the study period. Patients ≥80 years were less likely to receive actual treatment with antithrombotic medications (p = 0.002) and lipid-lowering medications (p = 0.005) but were more likely to receive antihypertensive medications (p = 0.0007) than their younger counterparts. With regard to optimal treatment (defined as receipt of, or a valid contraindication to, treatment in each category), those ≥80 were equally likely to receive antithrombotic medications and lipid therapy but remained more likely to receive antihypertensive treatment (77.7 vs 67.0%; p = 0.0007). There were no differences in receipt of optimal combination therapy (defined as optimal treatment in all three therapeutic classes) between patient age groups, even when adjusted for medical history.
Conclusion: After hospitalization for stroke or TIA, no differences in overall optimal treatment prescription of secondary-prevention medications between patients ages ≥80 and their younger counterparts were observed.
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