Fish oil administration in older adults with cardiovascular disease or cardiovascular risk factors: Is there potential for adverse events? A systematic review of the literature

2013 ◽  
Vol 168 (4) ◽  
pp. 4371-4375 ◽  
Author(s):  
Anthony M. Villani ◽  
Maria Crotty ◽  
Leslie G. Cleland ◽  
Michael J. James ◽  
Robert J. Fraser ◽  
...  
2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Anthony M Villani ◽  
Maria Crotty ◽  
Leslie G Cleland ◽  
Michael J James ◽  
Robert J Fraser ◽  
...  

2020 ◽  
Vol 11 ◽  
Author(s):  
Lin Cong ◽  
Yifei Ren ◽  
Tingting Hou ◽  
Xiaolei Han ◽  
Yi Dong ◽  
...  

Cardiovascular risk factors and related disorders are common among older adults, and use of various classes of cardiovascular (CV) drugs could reduce the risk of cardiovascular disease (CVD). However, data are sparse with regard to the use of CV drugs among rural-dwelling older adults in China. Therefore, this population-based study aimed to describe use of CV drugs among older adults living in the rural communities in China, while taking into account the use of CV drugs for primary and secondary prevention of CVDs. This study included 5,246 participants (age ≥65 years; 57.17% women; 40.68% illiteracy) in the baseline examination of the MIND-China study. In March-September 2018, data on health-related factors, CVDs (ischemic heart disease, atrial fibrillation, heart failure, and stroke), and CV drug use were collected via face-to-face survey, clinical examination, and laboratory tests. We classified CV drugs according to the Anatomical Therapeutic Chemical classification system for western medications and specific cardiovascular effects for the products of traditional Chinese medicine (TCM). We conducted descriptive analysis. The overall prevalence of major cardiovascular risk factors ranged from 14.30% in diabetes and 23.81% in dyslipidemia to 66.70% in hypertension, and CVDs affected 35.07% of all participants (36.28% in women vs. 33.47% in men, p = 0.035). In the total sample, calcium channel blockers (C08) were most commonly used (10.39%), followed by TCM products (7.64%), hypoglycemic agents (A10, 4.73%), renin-angiotensin system (RAS)-acting agents (C09, 4.61%), and lipid-lowering agents (C10, 4.17%). The proportions of CV drugs for primary prevention (i.e., use of CV drugs among people without CVD) were 3.14% for antithrombotic agents (mainly aspirin), 1.38% for lipid-lowering agents, and 3.11% for RAS-acting agents; the corresponding figures for secondary prevention (i.e., use of CV drugs among people with CVD) were 13.97%, 9.35%, and 7.39%. In conclusion, despite highly prevalent cardiovascular risk factors and CVDs, a fairly low proportion of the rural-dwelling older adults take CV medications for primary and secondary prevention. Notably, TCM products are among the most commonly used CV drugs. These results call for additional efforts to promote implementation of the evidence-based recommendations for prevention of CVDs in the primary care settings.


2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
J Masoli ◽  
J Atkins ◽  
J Delgado ◽  
L Pilling ◽  
D Melzer

Abstract Background Older adults are at increased risk of COVID-19, resulting in public health shielding measures for all adults over 70 in the UK. Frailty has been proposed for risk stratification in COVID-19 with limited evidence. Cardiovascular risk factors hypertension, diabetes and raised BMI have been associated with increased COVID-19 risk. We sought to test if non-frail older adults with low cardiovascular risk had reduced COVID-19, to inform targeted shielding policies. Methods Fried and Rockwood frailty were ascertained at UK Biobank baseline (2006-2010) and electronic frailty index(eFI) in primary care data to 2017*. A cardiovascular disease risk score(CRS) consisting of smoking status, LDL-cholesterol, blood pressure, BMI, fasting glucose and physical activity was estimated at baseline. Frailty (baseline and eFI; eFI alone) and CRS were tested in logistic models against COVID-19 status and COVID-19 mortality to 14th June 2020 adjusted for demographics and technical covariates. Results N=269,164 UKB participants aged ≥65 at baseline (≥75years in 2020). 13.9% of COVID-19 positive were non-frail with low baseline CRS versus 41.8% frail with moderate/high CRS. Being non-frail and having low CRS were independently associated with reduced COVID-19. The composite of non-frail with low CRS compared to frail with moderate/high CRS had significantly reduced COVID-19 risk (composite non-frail with low CRS HR 0.61; 95% CI 0.45-0.84; p=0.0023; eFI non-frail with low CRS HR 0.16; 95%CI 0.07-0.36; p value=9.9x10-6) and COVID-19 mortality (composite non-frail HR 0.28; 95% CI 0.10-0.82; pvalue=0.02; eFI non-frail 0.07; 95% CI 0.02-0.28; pvalue=0.00014). Conclusion These results show that the COVID-19 risk in non-frail older adults with low cardiovascular risk was up to 84% lower than in those who were frail with cardiovascular risk factors. This could contribute to future work on stratification of shielding risk in older adults in future COVID-19 surges. *Planned data updates prior to the conference should enable updates to 2020.


2014 ◽  
Vol 92 (0) ◽  
pp. 9-14 ◽  
Author(s):  
C. van Durme ◽  
I. A. A. M. van Echteld ◽  
L. Falzon ◽  
D. Aletaha ◽  
D. M. F. M. van der Heijde ◽  
...  

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Cynthia Lim ◽  
Jason Choo ◽  
Jia Liang Kwek ◽  
Hanis Abdul Kadir ◽  
Ngiap Chuan Tan

Abstract Background and Aims Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with cardiovascular and kidney adverse effects, especially in older adults. However, NSAIDs are still frequently prescribed to some at-risk groups. We aimed to evaluate the burden of traditional cardiovascular risk factors and pattern of NSAID prescription in the very-old and young-old. Method Cross-sectional study of older adults who received prescriptions over 3 years from a large healthcare cluster in Singapore. Individuals aged 65-79 years were the “young-old” and those ≥80 years were the “very-old”. Prescriptions and traditional cardiovascular risk factors were retrieved from electronic records. Results Among 197,932 older adults (including 41,079 very-old), 49.9% received at least 1 NSAID prescription. Topical NSAIDs were more frequently prescribed among the 19,979 very-old with NSAID prescriptions (91.5% versus 82.9% of the young-old), while oral non-selective (22.1% versus 38.5%) and selective NSAID (15.1% versus 24.9%) were less frequently prescribed compared to the young-old (all p<0.001). The very-old with NSAID prescriptions were more likely to have diabetes (38.2% vs. 32.8%), hypertension (19.3% vs. 14.0%), chronic kidney disease (51.4% vs. 23.6%) and cardiovascular disease (7.0% vs. 3.8%) than the young-old with NSAID prescriptions (all p<0.001). Table 1 shows that among the very-old, the odds of receiving oral non-selective NSAIDs was significantly lower in those with cardiovascular disease, while the odds of receiving oral COX II inhibitors was significantly higher in female and hypertension. Among the young-old, the odds of receiving oral non-selective NSAID was lower in those with cardiovascular disease, diabetes and chronic kidney disease, while the odds of receiving oral COX II inhibitors was higher in female, hypertension, cardiovascular disease and lower in diabetes and chronic kidney disease. Conclusion This study highlights that NSAIDs were frequently prescribed among older adults with comorbidities that may predispose to NSAID-associated adverse events. Physician education and policies are required to avoid potentially inappropriate prescriptions.


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