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Elderly Asthmatic Patients

Elderly Asthmatic Patients We read with interest the article by Diette and associates1 published in the May 27, 2002, issue of the ARCHIVES. The authors reported that 91% of elderly asthmatic patients had at least 1 comorbid condition such as sinusitis, heartburn, or chronic bronchitis. We propose that arrhythmia and coronary disease are much more important comorbid diseases because theophylline and β-agonist use can affect cardiac function.2,3 However, there was no information about these comorbid diseases in the article. How many patients had these comorbid diseases? In our elderly asthmatic patients, 7.5% and 5% of patients had arrhythmia and coronary disease, respectively. The authors showed that comorbid illness was one of the predictors of future hospitalization. We would appreciate knowing about the causes for hospitalization of the elderly because the asthmatic patients were admitted to the hospital because of uncontrolled asthmatic status not because of deterioration of a comorbid condition. The authors reported that 71.1% of elderly asthmatics had used inhaled corticosteroids (ICS) and that this rate was much higher than that of younger patients.1 However, prophylactic use of ICS in elderly patients was not different from that in younger patients, and ICS use for treatment of worsening symptoms in elderly patients was lower than that in younger patients. We assume that ICS use is problematic in some elderly patients4 and that elderly asthmatic patients may be less likely to use ICS, although the authors reported the underuse of ICS in the elderly compared with younger patients. We would appreciate the authors' comments on ICS use in elderly asthmatic patients. References 1. Diette GBKrishnan JADominici FD et al. Asthma in older patients: factors associated with hospitalization. Arch Intern Med. 2002;1621123- 1132Google ScholarCrossref 2. Conradson TBEklundh GOlofsson BPahlm OPersson G Cardiac arrhythmias in patients with mild-to-moderate obstructive lung disease: comparison of beta-agonist therapy alone and in combination with a xanthine derivative, enprofylline or theophylline. Chest. 1985;88537- 542Google ScholarCrossref 3. Bittar GFriedman HS The arrhythmogenicity of theophylline: a multivariate analysis of clinical determinants. Chest. 1991;991415- 1420Google ScholarCrossref 4. Kurishima KSatoh HYamashita YTOhtsuka MSekizawa K The oldest patient with bronchial asthma. Australas J Ageing. 2001;2092- 93Google ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Elderly Asthmatic Patients

Abstract

We read with interest the article by Diette and associates1 published in the May 27, 2002, issue of the ARCHIVES. The authors reported that 91% of elderly asthmatic patients had at least 1 comorbid condition such as sinusitis, heartburn, or chronic bronchitis. We propose that arrhythmia and coronary disease are much more important comorbid diseases because theophylline and β-agonist use can affect cardiac function.2,3 However, there was no information about these comorbid diseases in the...
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Publisher
American Medical Association
Copyright
Copyright © 2003 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.163.1.122-a
Publisher site
See Article on Publisher Site

Abstract

We read with interest the article by Diette and associates1 published in the May 27, 2002, issue of the ARCHIVES. The authors reported that 91% of elderly asthmatic patients had at least 1 comorbid condition such as sinusitis, heartburn, or chronic bronchitis. We propose that arrhythmia and coronary disease are much more important comorbid diseases because theophylline and β-agonist use can affect cardiac function.2,3 However, there was no information about these comorbid diseases in the article. How many patients had these comorbid diseases? In our elderly asthmatic patients, 7.5% and 5% of patients had arrhythmia and coronary disease, respectively. The authors showed that comorbid illness was one of the predictors of future hospitalization. We would appreciate knowing about the causes for hospitalization of the elderly because the asthmatic patients were admitted to the hospital because of uncontrolled asthmatic status not because of deterioration of a comorbid condition. The authors reported that 71.1% of elderly asthmatics had used inhaled corticosteroids (ICS) and that this rate was much higher than that of younger patients.1 However, prophylactic use of ICS in elderly patients was not different from that in younger patients, and ICS use for treatment of worsening symptoms in elderly patients was lower than that in younger patients. We assume that ICS use is problematic in some elderly patients4 and that elderly asthmatic patients may be less likely to use ICS, although the authors reported the underuse of ICS in the elderly compared with younger patients. We would appreciate the authors' comments on ICS use in elderly asthmatic patients. References 1. Diette GBKrishnan JADominici FD et al. Asthma in older patients: factors associated with hospitalization. Arch Intern Med. 2002;1621123- 1132Google ScholarCrossref 2. Conradson TBEklundh GOlofsson BPahlm OPersson G Cardiac arrhythmias in patients with mild-to-moderate obstructive lung disease: comparison of beta-agonist therapy alone and in combination with a xanthine derivative, enprofylline or theophylline. Chest. 1985;88537- 542Google ScholarCrossref 3. Bittar GFriedman HS The arrhythmogenicity of theophylline: a multivariate analysis of clinical determinants. Chest. 1991;991415- 1420Google ScholarCrossref 4. Kurishima KSatoh HYamashita YTOhtsuka MSekizawa K The oldest patient with bronchial asthma. Australas J Ageing. 2001;2092- 93Google ScholarCrossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 13, 2003

Keywords: asthma,older adult

References