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.
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 hypertensivemen 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.
Authors: Graziano Onder; Brenda W J H Penninx; Rajesh Balkrishnan; Linda P Fried; Paulo H M Chaves; Jeff Williamson; Christy Carter; Mauro Di Bari; Jack M Guralnik; Marco Pahor Journal: Lancet Date: 2002-03-16 Impact factor: 79.321
Authors: Françoise Forette; Marie-Laure Seux; Jan A Staessen; Lutgarde Thijs; Marija-Ruta Babarskiene; Speranta Babeanu; Alfredo Bossini; Robert Fagard; Blas Gil-Extremera; Tovio Laks; Zhanna Kobalava; Cinzia Sarti; Jaakko Tuomilehto; Hannu Vanhanen; John Webster; Yair Yodfat; Willem H Birkenhäger Journal: Arch Intern Med Date: 2002-10-14
Authors: Dennis T Ko; Patricia R Hebert; Christopher S Coffey; Artyom Sedrakyan; Jeptha P Curtis; Harlan M Krumholz Journal: JAMA Date: 2002-07-17 Impact factor: 56.272
Authors: Mary E Tinetti; Gail J McAvay; Terri R Fried; Heather G Allore; Joanna C Salmon; Joanne M Foody; Luann Bianco; Sandra Ginter; Liana Fraenkel Journal: J Am Geriatr Soc Date: 2008-07-24 Impact factor: 5.562