Association Between Antihypertensive Medication Use and Non-cardiovascular Outcomes in Older Men
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- Cite this article as:
- Agostini, J.V., Tinetti, M.E., Han, L. et al. J GEN INTERN MED (2007) 22: 1661. doi:10.1007/s11606-007-0388-9
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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.
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.
544 community-dwelling hypertensive men over age 65 years.
Timed chair stands; Trail Making Test part B; and Centers for Epidemiologic Studies Depression (CES-D) scores.
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.
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.