OBJECTIVE: The aim of this study was to evaluate intervention of drug treatment to elderly patients with cardiovascular diseases living in nursing homes and assess the effect of this intervention. METHOD: Eighty patients living in nursing homes in the County of Stockholm were randomized into 2 groups, 43 to the intervention group (average age 87 years) and 37 to the control group (average age 85 years). Patients included had diagnoses of heart failure, post myocardial infarction or cardiac valvular disease. Patients with drug treatment related to these diagnoses were also included. At a first visit a research nurse interviewed each patient to collect data of symptoms and health-related quality of life. The drug therapy was recorded. After reviewing medication, specialists in clinical pharmacology and cardiology suggested changes in the cardiovascular drug therapy to the responsible physician. At each following visit the current drug therapies as well as data of symptoms and health-related quality of life were recorded. RESULTS: The outcome was measured as scores of symptoms. Changes of total Health Index, ADL scores and deaths were recorded as well. The patients in the intervention group initially consumed 9.8 drugs on the average. For the control group this figure was 9.2 drugs. A change of cardiovascular drug therapy was suggested for 40 patients. Thirty-two changes in 19 patients were carried out, mainly regarding furosemide and potassium. Suggestions to initiate treatment with ACE-inhibitors were never followed. There were no significant changes in the scores of symptoms, total Health Index or ADL scores. CONCLUSIONS: The self-reported symptoms for each patient were helpful as a guide for the specialists to evaluate the drug therapy. The intervention resulted in reduction of drug use in half of the patients in the intervention group without any negative effects on health of symptoms.