January 10, 2026Nature Reviews Cardiology0 citations
Optimizing cardiovascular pharmacotherapy in older adults with frailty
Key Result
Individualized cardiovascular pharmacotherapy is essential for older adults with frailty to balance reducing events with minimizing adverse effects.
Key Points
- The aim is to examine the unique challenges of administering cardiovascular drugs to older adults with frailty.
- Review of the pharmacotherapeutic challenges in older adults with frailty.
- Analysis of approaches for blood pressure control, glucose lowering, and lipid management.
- Discussion on antiplatelet therapies and anticoagulants in atrial fibrillation.
- Consideration of treatment risks and individual health status in medication choice.
- Highlighted the increased risk of adverse effects from cardiovascular medications in frail older adults.
- Emphasized the need for individualized treatment plans based on personal health goals.
- Demonstrated the importance of considering both efficacy and safety in pharmacotherapy.
Structured PICO
P
Population
Older adults with frailty and cardiovascular diseases
I
Intervention
Cardiovascular pharmacotherapy (including antihypertensives, glucose-lowering agents, statins, antiplatelets, direct oral anticoagulants, and heart failure medications)
Cardiovascular pharmacotherapy in frail older adults requires a personalized approach that carefully weighs the benefits of treatment against the heightened risk of adverse drug effects.
Main Result
Absolute Event Rate: 0% vs 0%
Abstract
The prevalence of frailty and its effect on cardiovascular outcomes is increasing on a global scale. Pharmacotherapies for cardiovascular diseases in older people with frailty present unique challenges that require a comprehensive and individualized approach. In this Review, we provide a general overview of these challenges, followed by an in-depth discussion of the problems inherent in applying standard approaches to cardiovascular care in this population. Specifically, we consider blood pressure control, glucose lowering in patients with type 2 diabetes mellitus, lipid lowering, antiplatelet therapies, direct oral anticoagulants for stroke prevention in atrial fibrillation, and the treatment of heart failure. Although the reduction in cardiovascular events in older individuals with frailty is crucial, the potentially increased risk of adverse effects with the use of cardiovascular medications must be carefully considered. Treatment targets and the choice of drug for these patients should be based on their overall health status and personal goals of care.