Use of beta-blockers for uncomplicated hypertension in the elderly: a cause for concern
Beta-blockers are less beneficial than other antihypertensive drugs in the elderly with hypertension. All elderly patients in Ontario, Canada (population over 3.5 million elderly) without co-morbidities who were first treated for hypertension with a beta-blocker were studied in a retrospective popul...
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Published in | Journal of human hypertension Vol. 21; no. 4; pp. 271 - 275 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
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Nature Publishing Group
01.04.2007
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Abstract | Beta-blockers are less beneficial than other antihypertensive drugs in the elderly with hypertension. All elderly patients in Ontario, Canada (population over 3.5 million elderly) without co-morbidities who were first treated for hypertension with a beta-blocker were studied in a retrospective population-based cohort study (1994-2002) to determine the characteristics of those prescribed beta-blockers. Of the 194,761 patients in our cohort, 25 485 (13%) were prescribed a beta-blocker as their first antihypertensive agent. On multivariate analysis, factors significantly associated with being prescribed a beta-blocker as first-line therapy included male sex (adjusted odds ratio (OR) 1.06 [95% CI 1.03-1.09] vs women), younger age (adjusted OR 1.67 [95% CI 1.55-1.79] for patients aged 66-69 vs those aged 85 or older), residence in a long-term care facility (adjusted OR 1.19 [95% CI 1.04-1.35] vs living in the community) and lower socioeconomic status (adjusted OR 1.07 [95% CI 1.02-1.12], for lowest quintile vs highest quintile). Patients with diabetes were substantially less likely to be prescribed beta-blockers (adjusted OR 0.42 [95% CI 0.40-0.44]). Greater efforts are required to educate physicians to select other drugs for initial therapy in older patients with uncomplicated hypertension. |
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AbstractList | Beta-blockers are less beneficial than other antihypertensive drugs in the elderly with hypertension. All elderly patients in Ontario, Canada (population over 3.5 million elderly) without co-morbidities who were first treated for hypertension with a beta-blocker were studied in a retrospective population-based cohort study (1994-2002) to determine the characteristics of those prescribed beta-blockers. Of the 194,761 patients in our cohort, 25 485 (13%) were prescribed a beta-blocker as their first antihypertensive agent. On multivariate analysis, factors significantly associated with being prescribed a beta-blocker as first-line therapy included male sex (adjusted odds ratio (OR) 1.06 [95% CI 1.03-1.09] vs women), younger age (adjusted OR 1.67 [95% CI 1.55-1.79] for patients aged 66-69 vs those aged 85 or older), residence in a long-term care facility (adjusted OR 1.19 [95% CI 1.04-1.35] vs living in the community) and lower socioeconomic status (adjusted OR 1.07 [95% CI 1.02-1.12], for lowest quintile vs highest quintile). Patients with diabetes were substantially less likely to be prescribed beta-blockers (adjusted OR 0.42 [95% CI 0.40-0.44]). Greater efforts are required to educate physicians to select other drugs for initial therapy in older patients with uncomplicated hypertension. |
Audience | Academic |
Author | Tu, K Chen, Z McAlister, F A Campbell, N R C |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/17287848$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1016_j_jaad_2008_10_062 crossref_primary_10_1080_17425255_2019_1588249 crossref_primary_10_1080_08037050802305578 crossref_primary_10_2165_00151234_200705280_00015 crossref_primary_10_3233_JAD_161234 crossref_primary_10_1038_sj_jhh_1002144 crossref_primary_10_1111_j_1524_6175_2007_08030_x crossref_primary_10_1016_j_cjca_2012_05_006 |
Cites_doi | 10.1016/S0828-282X(07)70827-9 10.1016/S0140-6736(04)17355-8 10.1016/S0140-6736(05)67186-3 10.1016/S0828-282X(06)70281-1 10.1136/bmj.291.6488.97 10.1016/S0140-6736(05)67573-3 10.1016/S0828-282X(06)70276-8 10.1016/S0140-6736(02)08090-X 10.1503/cmaj.060110 10.1161/01.HYP.0000164573.01177.95 10.1038/sj.jhh.1001683 10.1136/bmj.305.6868.1554 10.1016/S0140-6736(05)67575-7 10.1136/bmj.304.6824.405 10.1097/00004872-200306000-00002 10.1097/00004872-199917020-00001 10.1161/01.CIR.88.4.1973 10.1016/S0828-282X(06)70277-X 10.1001/jama.279.23.1903 10.1161/01.HYP.0000196269.98463.fd 10.1016/S0140-6736(05)70151-3 10.1016/0021-9681(87)90171-8 |
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SubjectTerms | Adrenergic beta blockers Adrenergic beta-Antagonists - therapeutic use Age Factors Aged Aged, 80 and over Analysis of Variance Antihypertensive Agents - therapeutic use Antihypertensives Assisted Living Facilities Beta blockers Confounding Factors (Epidemiology) Diabetes mellitus Diagnosis Dosage and administration Drug therapy Drug Utilization - trends Female Health aspects Humans Hypertension Hypertension - drug therapy Hypertension - epidemiology Male Multivariate analysis Ontario - epidemiology Population studies Predictive Value of Tests Prevalence Research Design Retrospective Studies Sex Factors Sex ratio Social Class Treatment Outcome |
Title | Use of beta-blockers for uncomplicated hypertension in the elderly: a cause for concern |
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