Antihypertensive ADRs impact clinical practice in very old
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Antihypertensive ADRs impact clinical practice in very old Although the HYVET* trial showed benefits of antihypertensives in the very elderly, in clinical practice such interventions to reach recommended BP targets are limited due to ADRs. This was the finding of a retrospective cohort study undertaken by researchers in the UK. They identified 100 hypertensive patients aged ≥ 80 years who attended a hypertension research clinic between April 1998 and May 2008. Patients were categorised according to the mean daytime BP, measured by ambulatory BP monitoring, and whether they were medicated or unmedicated. A total of 64 patients were classed as having poorly controlled BP, despite 57 receiving treatment. Of these, the occurrence of ADRs led to discontinuation of antihypertensive therapy in 15 patients, a dosage reduction in 3 patients and no change in 9 patients; 1 patient remained unmedicated because of ADRs. Of the 28 patients who had well controlled BP and were medicated, 10 had discontinued antihypertensives due to ADRs and 5 had dosage reductions. The ADRs reported included calcium channel antagonist-induced ankle oedema, cold extremities and heart block due to βblockers, ACE inhibitor-induced headache and renal impairment due to ACE inhibitors, angiotensin II receptor antagonists or diuretics. * Hypertension in the Very Elderly Trial Butt TF, et al. Managing hypertension in the very elderly: effect of adverse drug reactions (ADRs) on achieving targets. Journal of Human Hypertension : 4 Feb 803006229 2010. Available from: URL: http://dx.doi.org/10.1038/jhh.2009.116
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Reactions 20 Feb 2010 No. 1289
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