Antihypertensive Medication Often Prescribed Needlessly to Seniors

A significant proportion of patients over 70 remain on antihypertensive medication despite already having a lower blood pressure (BP), according to a new study.

Researchers at the University of Kent (Canterbury, United Kingdom) and East Kent Hospitals University NHS Foundation Trust (Canterbury, United Kingdom) conducted a retrospective observational cohort study in 11,167 patients over 70 years old (57% female) to assess the prevalence of low BP and impact on outcomes, particularly in the presence of ongoing antihypertensive treatment.

The results revealed that a systolic BP below 120 mmHg was present in 1,297 people (844 of them on antihypertensive medication), below 110 mmHg in 474 people (313 of them on antihypertensive medication) and below 100 mmHg in 128 people (89 of them on antihypertensive medication). In all, of 1,899 people with some degree of low BP, 1,246 were on medication. The researchers also found that the hypotension was independently associated with mortality, acute kidney injury, and hospital admission. The study was published on June 30, 2016, in Age and Aging.

“Treating hypertension in old age reduces strokes and other cardiovascular events. However, in elderly patients with multiple risks, there is a trade-off between using antihypertensives to reduce the risk of future disease and increased risk due to adverse effects of medication,” said senior author consultant renal physician Professor Chris Farmer, MD, of the University of Kent. “Once medication is initiated, it is not always regularly reviewed to adjust for physiological changes associated with ageing and the effects of additional drugs.”

For people who exercise regularly and are in top physical condition, hypotension is a sign of good health and fitness, but for many, excessively low BP can lead to orthostatic hypotension, causing dizziness and fainting. Severely low blood pressure can deprive the brain and other vital organs of oxygen and nutrients, leading to shock. Orthostatic hypotension can be caused by diuretics, alpha and beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors.

Related Links:
University of Kent
East Kent Hospitals University NHS Foundation Trust