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首页> 外文期刊>Cardiology in review >Gender-specific implications for cardiovascular medication use in the elderly optimizing therapy for older women.
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Gender-specific implications for cardiovascular medication use in the elderly optimizing therapy for older women.

机译：老年人中心血管药物使用的性别特异性影响优化了老年妇女的治疗方法。

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Sex should be considered during the selection of cardiovascular medications and dosages of cardiovascular medications. There is mounting evidence that clinically important differences between the sexes exist in the pharmacokinetic processes that determine drug concentrations and in the pharmacodynamic processes that determine physiologic responses to pharmacologic agents. Although aging also affects these processes, aging does not eliminate the sex-related differences. The major pharmacokinetic differences between the sexes, on average, are lower weight and distribution volumes in women compared with men and lower renal drug clearance in women compared with men. Sex-related differences in hepatic drug clearance are less predictable. Pharmacodynamic responses that differ between the sexes include increased adverse cardiovascular drug effects in women compared with men (torsade de pointes arrhythmias, increased risk of hemorrhagic consequences of anticoagulation or thrombolytic therapy, electrolyte abnormalities with diuretics, myopathy with HMG Co-A reductase inhibitors, cough with ACE inhibitors, and increased incidence of thrombosis). Recommendations for optimizing cardiovascular drug therapy for the older women include individualization of drug selection to minimize the number of medications and side effects; dosage adjustment based on age, size, and sex; close monitoring for side effects; and consideration of cost and access to medications. Optimal care for the older woman with cardiovascular disease will also require investigation of cardiovascular medications in older women and of therapies for cardiovascular diseases that are more common in women than men.
机译：在选择心血管药物和心血管药物剂量时应考虑性别。越来越多的证据表明，性别之间在临床上的重要差异存在于确定药物浓度的药代动力学过程和确定对药理剂的生理反应的药效动力学过程中。尽管衰老也会影响这些过程，但衰老并不能消除性别相关的差异。平均而言，男女之间的主要药代动力学差异是，女性的体重和分布体积比男性低，而女性的肾药物清除率比男性低。与性别相关的肝药物清除率差异难以预测。男女之间的药效学反应有所不同，包括女性与男性相比心血管药物不良反应增加（扭转性心律失常，抗凝或溶栓治疗的出血后果风险增加，利尿剂电解质异常，HMG Co-A还原酶抑制剂引起的肌病，咳嗽使用ACE抑制剂，并增加血栓形成的发生率）。为老年妇女优化心血管药物治疗的建议包括个体化药物选择以最大程度地减少用药次数和副作用。根据年龄，大小和性别调整剂量;密切监测副作用;并考虑费用和获得药物的机会。对患有心血管疾病的老年妇女的最佳护理还需要对老年妇女的心血管药物进行研究，并研究女性比男性更常见的心血管疾病疗法。

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