Digitalis Therapy in a 70‐Year‐Old Population

Abstract

In the population study “70‐year‐old people in Gothenburg” 14% of the probands were found to be undergoing treatment with digitalis, 6% with digoxin, 6% with digitoxin and 2% with other glycosides. A comparison between results of the interview method and those of S‐digoxin analyses indicates that the interview method was acceptable. As far as can be judged from S‐digoxin analyses, only about 60% of the treated patients were on a dosage considered to be effective and free from obvious risks of side‐effects. Out of the 130 70‐year‐olds who were on digitalis treatment, 37% had obvious symptoms of heart disease requiring such treatment, 34% lacked symptoms of arrhythmia and/or congestive failure but had heart volumes larger than those used as reference values in younger age groups, and 29% had no symptoms indicating digitalis treatment. At least 13% of the population had indications for digitalis therapy and about 75% of those apparently needing digitalis were on such treatment. Thus both over‐ and underdiagnosis of heart disease requiring digitalis therapy were common in this age group.

Drug Treatment in 70–82‐year‐old Persons

“…In order to reduce the errors which follow with the interview technique, a registered nurse visited the subjects in their own homes and asked and helped the probands to put all drugs they used on a table whereafter the interview was performed. We have also made a control with S-digoxin analyses to test the reliability of the interview which was found to be very good for this drug (9). The high consumption does not reflect a corresponding high prevalence of diseases in the examined population.…”

“…We have tried to estimate the total prevalence of definable disorders and have found that 3040% of the probands at the age of 70 lacked diseases requiring drug treatment (10). Treatment for congestive heart failure and hypertension dominated and also for these diseases we have been able to show that there is a considerable overtreatment (9). Although the women were found to be healthier, they used more drugs than the men.…”

Is Maintenance Digoxin Necessary in Geriatric Patients?

“…Digitalis is one of the most frequently prescribed drugs, especially among elderly people. Landahl et al (9) reported that 14% of the 70-year-old persons in Gothenburg were receiving digitalis. This treatment, that is sometimes initiated without any real indication (2,8,9), is seldom withdrawn.…”