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Association Between Antihypertensive Medication Use and Non-cardiovascular Outcomes in Older Men

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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.

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Acknowledgments

The authors want to thank Gregory Acampora, M.D., for assistance with data abstraction, Gail McAvay, Ph.D., for database management, and M. Carrington Reid, M.D., Ph.D., for assembling the original patient cohort. Dr. Agostini was supported by a VA Health Services Research Career Development Award and the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (#P30AG21342). Dr. Foody was supported by a National Institutes of Health/National Institute on Aging (NIH/NIA) Career Development Award (K08-AG20623-01) and a NIA/Hartford Foundation Fellowship in Geriatrics. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The principal investigator had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

Conflict of Interest

Dr. Foody has received speaker honoraria from Merck and Pfizer. There are no other potential conflicts of interest to disclose.

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Authors and Affiliations

  1. Clinical Epidemiology Research Center 151B, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, USA

    Joseph V. Agostini MD & John Concato MD, MS

  2. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA

    Joseph V. Agostini MD, Mary E. Tinetti MD, Ling Han MD, PhD, JoAnne M. Foody MD & John Concato MD, MS

  3. Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA

    Mary E. Tinetti MD & Peter Peduzzi PhD

  4. VA Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA

    Peter Peduzzi PhD

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  1. Joseph V. Agostini MD
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Correspondence to Joseph V. Agostini MD.

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Agostini, J.V., Tinetti, M.E., Han, L. et al. Association Between Antihypertensive Medication Use and Non-cardiovascular Outcomes in Older Men. J GEN INTERN MED 22, 1661–1667 (2007). https://doi.org/10.1007/s11606-007-0388-9

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  • DOI: https://doi.org/10.1007/s11606-007-0388-9

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