Although elderly patients represent a rapidly growing population often requiring multiple drug treatment, the evidence of effectiveness is limited for many interventions and therapies in this age group. Only during the last 30 years has a requirement to incorporate evidence into the treatment of older subjects become part of the pre- and postmarketing regulatory process in Europe and the United States. Recently, elderly patients have been shown to benefit comparably from several treatments. These studies have supported the validity of an increasingly interventional approach to disorders common in late life. However, an important issue is the applicability of the growing body of clinical trials to 'real life' patients. This is particularly true in very old (i.e. >80 years) patients and those with significant comorbidities. We review the current evidence and controversies related to the effectiveness and safety of several therapeutic strategies in cardiovascular disease (i.e. statins, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, beta-adrenoceptor blockers, and thrombolytic agents) and bone health (i.e. vitamin D and bisphosphonates).

译文

尽管老年患者是一个快速增长的人群,经常需要多种药物治疗,但该年龄段的许多干预措施和疗法的有效性证据有限。只有在过去的30年中,才需要将证据纳入老年受试者的治疗中,这成为欧洲和美国上市前和上市后监管过程的一部分。最近,老年患者已被证明从几种治疗中受益。这些研究支持了对晚年常见疾病的日益介入的方法的有效性。然而,一个重要的问题是越来越多的临床试验对 “现实生活” 患者的适用性。在非常老 (即> 80岁) 的患者和有严重合并症的患者中尤其如此。我们回顾了与心血管疾病 (即他汀类药物,血管紧张素转化酶抑制剂,血管紧张素受体阻滞剂,β-肾上腺素受体阻滞剂和血栓溶解剂) 和骨骼健康 (即维生素d和双膦酸盐) 的有效性和安全性相关的当前证据和争议。

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