Use of beta-blockers for uncomplicated hypertension in the elderly: a cause for concern

• Published in: Journal of human hypertension Vol. 21; no. 4; pp. 271 - 275
• Main Authors: Tu, K, Campbell, N R C, Chen, Z, McAlister, F A
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.04.2007
• Subjects: 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; Ontario; Canada
• DOI: 10.1038/sj.jhh.1002128
• ISSN: 0950-9240

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.