Association between antihypertensive medication use and non-cardiovascular outcomes in older men

J Gen Intern Med. 2007 Dec;22(12):1661-7. doi: 10.1007/s11606-007-0388-9. Epub 2007 Sep 25.

Abstract

Background: Antihypertensive drugs are prescribed commonly in older adults for their beneficial cardiovascular and cerebrovascular effects, but few studies have assessed antihypertensive drugs' adverse effects on non-cardiovascular outcomes in routine clinical practice.

Objective: To evaluate, among older adults, the association between antihypertensive medication use and physical performance, cognition, and mood.

Design and setting: Prospective cohort study in a Veterans Affairs primary care clinic, with patients enrolled in 2000-2001 and assessed for medication use, comorbidities, health behaviors, and other characteristics; and followed-up 1 year later.

Participants: 544 community-dwelling hypertensive men over age 65 years.

Measurements: Timed chair stands; Trail Making Test part B; and Centers for Epidemiologic Studies Depression (CES-D) scores.

Results: Participants had a mean age of 74.4 +/- 5.2 years and took a mean of 2.3 +/- 1.2 antihypertensive medications at baseline. After adjustment for age, comorbidities, level of blood pressure, and other confounders, each 1-unit increase in antihypertensive medication "intensity" was associated with a 0.11-second (95% confidence interval, 0.05-0.16) increase in the time required to complete the timed chair stands. No significant relationship was found between antihypertensive medication intensity and outcomes for Trail Making B or CES-D scores.

Conclusions: A higher cumulative exposure to antihypertensive medications in community-living older men was associated with adverse effects on physical performance, but not on the cognitive or depression measures available in this study. Clinicians should consider non-cardiovascular related adverse effects when treating older males taking multiple antihypertensive medications.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Anti-Infective Agents / adverse effects*
  • Anti-Infective Agents / therapeutic use
  • Cognition / drug effects*
  • Comorbidity
  • Depression / chemically induced*
  • Drug Therapy, Combination
  • Health Behavior
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Motor Activity / drug effects*
  • Prospective Studies
  • Treatment Outcome

Substances

  • Anti-Infective Agents