Tolerability of Antihypertensive Medications: The Influence of Age.
Adverse effect
Adverse event
Blood pressure
Cough
Older adults
Journal
High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension
ISSN: 1179-1985
Titre abrégé: High Blood Press Cardiovasc Prev
Pays: New Zealand
ID NLM: 9421087
Informations de publication
Date de publication:
24 Apr 2024
24 Apr 2024
Historique:
received:
19
02
2024
accepted:
02
04
2024
medline:
25
4
2024
pubmed:
25
4
2024
entrez:
24
4
2024
Statut:
aheadofprint
Résumé
Despite high prevalence of hypertension, few studies have analysed the adverse effects (AEs) of antihypertensive medications, especially in older patients. To investigate the prevalence and associated factors of antihypertensive-related AEs, focusing on the influence of age on treatment tolerability. We retrospectively investigated antihypertensive-related AEs in patients evaluated at the Hypertension Clinic of Careggi Hospital, Florence, Italy, between January 2017 and July 2020. Multivariable regression models were generated to analyse variables associated with AEs in the overall sample and in participants ≥75 years. Among 622 subjects (mean age 64.8 years, 51.4% female), the most frequently reported AEs were calcium-channel blockers (CCB)-related ankle swelling (26.8%) and ACEi-induced cough (15.1%). Ankle swelling was more common in older patients (35.7% vs 22.3%, p = 0.001; odds ratio [OR] 1.94, 95%CI 1.289-2.912) and was independently associated with Body Mass Index (BMI, adjOR 1.073) and angiotensin-receptor antagonists (adjOR 1.864). The association with BMI was confirmed in older patients (adjOR 1.134). ACEi-induced cough showed similar prevalence in younger and older patients (13.9% vs 15.6%, p = 0.634), being independently associated with female sex (adjOR 2.118), gastroesophageal reflux disease (GERD, adjOR 2.488) and SNRI therapy (adjOR 8.114). The association with GERD was confirmed in older patients (adjOR 3.238). CCB-related ankle swelling and ACEi-induced cough represent the most common antihypertensive-related AEs, also at old age. Older patients showed a two-fold increased risk of ankle swelling, that was also independently associated with BMI. ACEi-induced cough had similar prevalence at younger and old ages, being independently associated with GERD.
Identifiants
pubmed: 38658522
doi: 10.1007/s40292-024-00639-z
pii: 10.1007/s40292-024-00639-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from. to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 1990;2021(398):957–80.
Zhang W, Zhang S, Deng Y, Wu S, Ren J, Sun G, Yang J, Jiang Y, Xu X, Wang TD, Chen Y, Li Y, Yao L, Li D, Wang L, Shen X, Yin X, Liu W, Zhou X, Zhu B, Guo Z, Liu H, Chen X, Feng Y, Tian G, Gao X, Kario K, Cai J. Trial of intensive blood-pressure control in older patients with hypertension. N Engl J Med. 2021;385:1268–79.
doi: 10.1056/NEJMoa2111437
pubmed: 34491661
Deng Y, Bai J, Yang X, Liu W, Guo Z, Zhang J, Huang R, Yang X, Yu C, Yu J, Guo X, Wu H, Liu P, Zhang W, Cai J, et al. Achieved systolic blood pressure and cardiovascular outcomes in 60–80-year-old patients: the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Eur J Prev Cardiol. 2023;30:1017–27.
doi: 10.1093/eurjpc/zwad142
pubmed: 37172116
WHO. International drug monitoring: the role of national centres, report of a WHO meeting [Geneva, September 20-25 1971]. 1972. https://iris.who.int/handle/10665/40968 . Accessed 30 Dec 2023
Tedla YG, Bautista LE. Drug side effect symptoms and adherence to antihypertensive medication. am J Hypertens. 2016;29:772–9.
doi: 10.1093/ajh/hpv185
pubmed: 26643686
Rivasi G, Rafanelli M, Mossello E, Brignole M, Ungar A. Drug-related orthostatic hypotension: beyond anti-hypertensive medications. Drugs Aging. 2020;2020(37):725–38.
doi: 10.1007/s40266-020-00796-5
Benetos A, Petrovic M, Strandberg T. Hypertension management in older and frail older patients. Circ Res. 2019;124:1045–60.
doi: 10.1161/CIRCRESAHA.118.313236
pubmed: 30920928
Kardas P, Lewek P, Matyjaszczyk M. Determinants of patient adherence: A review of systematic reviews. Front Pharmacol. 2013;4:91.
doi: 10.3389/fphar.2013.00091
pubmed: 23898295
pmcid: 3722478
Burnier M. Drug adherence in hypertension. Pharmacol Res. 2017;125(Pt B):142–149. https://doi.org/10.1016/j.phrs.2017.08.015 .
Butt TF, Branch RL, Beesley L, Martin U. Managing hypertension in the very elderly: effect of adverse drug reactions (ADRs) on achieving targets. J Hum Hypertens. 2010;24:514–8.
doi: 10.1038/jhh.2009.116
pubmed: 20130597
Rivasi G, Ceolin L, Capacci M, Matteucci G, Testa GD, Ungar A. Risks associated with intensive blood pressure control in older patients. Kardiol Pol. 2023;81:446–54.
doi: 10.33963/KP.a2022.0297
pubmed: 36999732
Sheppard JP, Koshiaris C, Stevens R, Lay-Flurrie S, Banerjee A, Bellows BK, Clegg A, Hobbs FDR, Payne RA, Swain S, Usher-Smith JA, McManus RJ. The association between antihypertensive treatment and serious adverse events by age and frailty: a cohort study. PLoS Med. 2023. https://doi.org/10.1371/journal.pmed.1004223 .
doi: 10.1371/journal.pmed.1004223
pubmed: 37075078
pmcid: 10155987
Alhawassi TM, Krass I, Pont LG. Antihypertensive-related adverse drug reactions among older hospitalized adults. Int J Clin Pharm. 2018;40:428–35.
doi: 10.1007/s11096-017-0583-7
pubmed: 29392477
Sharabi Y, Illan R, Kamari Y, Cohen H, Nadler M, Messerli FH, Grossman E. Diuretic induced hyponatraemia in elderly hypertensive women. J Hum Hypertens. 2002;16:631–5.
doi: 10.1038/sj.jhh.1001458
pubmed: 12214259
Dharmarajan TS, Dharmarajan L. Tolerability of antihypertensive medications in older adults. Drugs Aging. 2015;32:773–96.
doi: 10.1007/s40266-015-0296-3
pubmed: 26442857
Bangalore S, Kumar S, Messerli FH. Angiotensin-converting enzyme inhibitor associated cough: deceptive information from the physicians’ desk reference. Am J Med. 2010;123:1016–30.
doi: 10.1016/j.amjmed.2010.06.014
pubmed: 21035591
Vukadinović D, Vukadinović AN, Lavall D, Laufs U, Wagenpfeil S, Böhm M. Rate of cough during treatment with angiotensin-converting enzyme inhibitors: a meta-analysis of randomized placebo-controlled trials. Clin Pharmacol Ther. 2019;105:652–60.
doi: 10.1002/cpt.1018
pubmed: 29330882
Israili ZH, Hall WD. Cough and angioneurotic edema associated with angiotensin-converting enzyme inhibitor therapy. Ann Intern Med. 1992;117:234–42.
doi: 10.7326/0003-4819-117-3-234
pubmed: 1616218
Gregg LP, Richardson PA, Herrera MA, Akeroyd JM, Jafry SA, Gobbel GT, Wydermyer S, Arney J, Hung A, Matheny ME, Virani SS, Navaneethan SD. Documented adverse drug reactions and discontinuation of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in chronic kidney disease. Am J Nephrol. 2023;54:126–35.
doi: 10.1159/000530988
pubmed: 37231800
Dicpinigaitis PV. Angiotensin-converting enzyme inhibitor-induced cough. Chest. 2006;129:169S-173S.
doi: 10.1378/chest.129.1_suppl.169S
pubmed: 16428706
Wyskida K, Jura-Szołtys E, Smertka M, Owczarek A, Chudek J. Factors that favor the occurrence of cough in patients treated with ramipril–a pharmacoepidemiological study. Med Sci Monit. 2012;18:Pl21–8.
doi: 10.12659/MSM.883336
Borghi C, Veronesi M. Cough and ACE inhibitors: the truth beyond placebo. Clin Pharmacol Ther. 2019;105:550–2.
doi: 10.1002/cpt.1040
pubmed: 29468656
Cimolai N. Risk factors for angiotension-converting enzyme inhibitor-associated cough. J Clin Pharmacol. 2021;61:1251–2.
doi: 10.1002/jcph.1883
pubmed: 33969492
Cazzola I, Matera MG. 5-HT modifiers as a potential treatment of asthma. Trends Pharmacol Sci. 2000;21:13–6.
doi: 10.1016/S0165-6147(99)01408-X
pubmed: 10637649
Brugts JJ, Arima H, Remme W, Bertrand M, Ferrari R, Fox K, DiNicolantonio J, MacMahon S, Chalmers J, Zijlstra F, Caliskan K, Simoons ML, Mourad JJ, Boersma E, Akkerhuis KM. The incidence and clinical predictors of ACE-inhibitor induced dry cough by perindopril in 27,492 patients with vascular disease. Int J Cardiol. 2014;176:718–23.
doi: 10.1016/j.ijcard.2014.07.108
pubmed: 25189490
Yeşil S, Yeşil M, Bayata S, Postaci N. ACE inhibitors and cough. Angiology. 1994;45:805–8.
doi: 10.1177/000331979404500908
pubmed: 8092546
Sica DA. Pharmacotherapy review: calcium channel blockers. J Clin Hypertens (Greenwich). 2006;8:53–6.
doi: 10.1111/j.1524-6175.2005.04140.x
pubmed: 16407690
Liang L, Kung JY, Mitchelmore B, Cave A, Banh HL. Comparative peripheral edema for dihydropyridines calcium channel blockers treatment: A systematic review and network meta-analysis. J Clin Hypertens (Greenwich). 2022;24:536–54.
doi: 10.1111/jch.14436
pubmed: 35234349
Fogari R, Zoppi A, Derosa G, Mugellini A, Lazzari P, Rinaldi A, Fogari E, Preti P. Effect of valsartan addition to amlodipine on ankle oedema and subcutaneous tissue pressure in hypertensive patients. J Hum Hypertens. 2007;21:220–4.
doi: 10.1038/sj.jhh.1002140
pubmed: 17215848
Oakley R, Tharakan B. Vascular hyperpermeability and aging. Aging Dis. 2014;5:114–25.
pubmed: 24729937
pmcid: 3966670
Fogari R, Malamani GD, Zoppi A, Preti P, Vanasia A, Fogari E, Mugellini A. Comparative effect of lercanidipine and nifedipine gastrointestinal therapeutic system on ankle volume and subcutaneous interstitial pressure in hypertensive patients: a double-blind, randomized, parallel-group study. Curr Ther Res. 2000;61:850–62.
doi: 10.1016/S0011-393X(00)90012-2
Paracha MY, Khalid F, Qamar MA, Ali SL, Singh S, Rubab U, Anwar A, Hashmi AA. Relationship between clinical features and body mass index among hypertensive patients: a cross-sectional study. Cureus. 2020;12: e11615. https://doi.org/10.7759/cureus .
doi: 10.7759/cureus
pubmed: 33364132
pmcid: 7752797
Fogari R, Zoppi A. Effects of antihypertensive therapy on sexual activity in hypertensive men. Curr Hypertens Rep. 2002;4:202–10.
doi: 10.1007/s11906-002-0008-3
pubmed: 12003702
Messerli FH. Vasodilatory edema: a common side effect of antihypertensive therapy. Curr Cardiol Rep. 2002;4:479–82.
doi: 10.1007/s11886-002-0110-9
pubmed: 12379167
Savoia C, D’Agostino M, Lauri F, Volpe M. Angiotensin type 2 receptor in hypertensive cardiovascular disease. Curr Opin Nephrol Hypertens. 2011;20:125–32.
doi: 10.1097/MNH.0b013e3283437fcd
pubmed: 21245762
Makarounas-Kirchmann K, Glover-Koudounas S, Ferrari P. Results of a meta-analysis comparing the tolerability of lercanidipine and other dihydropyridine calcium channel blockers. Clin Ther. 2009;31:1652–63.
doi: 10.1016/j.clinthera.2009.08.010
pubmed: 19808126
Borghi C. Lercanidipine in hypertension. Vasc Health Risk Manag. 2005;1:173–82.
pubmed: 17319103
pmcid: 1993952
Quach K, Lvtvyn L, Baigent C, Bueti J, Garg AX, Hawley C, Haynes R, Manns B, Perkovic V, Rabbat CG, Wald R, Walsh M. The safety and efficacy of mineralocorticoid receptor antagonists in patients who require dialysis: a systematic review and meta-analysis. Am J Kidney Dis. 2016;68:591–8.
doi: 10.1053/j.ajkd.2016.04.011
pubmed: 27265777
Lamberts SW, van den Beld AW, van der Lely AJ. The endocrinology of aging. Science. 1997;278:419–24.
doi: 10.1126/science.278.5337.419
pubmed: 9334293
Rose LI, Underwood RH, Newmark SR, Kisch ES, Williams GH. Pathophysiology of spironolactone-induced gynecomastia. Ann Intern Med. 1977;87:398–403.
doi: 10.7326/0003-4819-87-4-398
pubmed: 907238