[Cardiovascular adverse effects of antimuscarinics used in the treatment of overactive bladder in the elderly : A review].
Effets cardio-vasculaires des traitements anticholinergiques à visée vésicale chez la personne âgée : une revue
Résumé
AIM:
The aim of this study was to review the evidence regarding the cardiovascular effects of urinary anticholinergic drugs in the elderly.
METHODS:
A literature review was conducted in October 2017 using the Medline/Pubmed database limiting the search to works in English or French.
RESULTS:
In total, 602 articles between March 1964 and October 2017 have been reported, 60 studies were analyzed, 19 were prospective trials. Geriatric population has a high prevalence of cardiovascular diseases (24.4% of heart diseases on 65-74years and 36.9% on ≥75years). More than 20% of the geriatric population has overactive bladder history and 41.43% of them use of antimuscarinic drugs. Evaluating the cardiovascular adverse effects of antimusarinics in the geriatric population is not easy because of exclusion of high-risk patients in trials. However, serious cardiovascular adverse effects were reported like atrial fibrillation, atrioventricular block or torsade de pointe. Further studies are needed especially in the "real life" in order to precise the exact prevalence of such cardiovascular alterations.
CONCLUSION:
Without conclusive evidence, potential cardiovascular adverse effects of anticholinergic agents used in overactive bladder must lead to a cautious prescription.