Using multiple blood pressure drugs linked to higher mortality

Long-heralded for saving lives, blood pressure medicines could have serious consequences among the over-80 elderly with low systolic blood pressure when multiple kinds are used, researchers announced this week.

While blood pressure drugs have proven benefits for hypertensive people, “observational studies in frail elderly patients have shown no or even an inverse relationship between BP and morbidity and mortality,” researchers noted in JAMA Internal Medicine (formerly the Archives of Internal Medicine).

More than 1,100 people over 80 years old living in French and Italian nursing homes were studied to assess mortality in institutionalized individuals based on systolic blood pressure levels and number of antihypertensive drugs.

“A significant interaction was found between low SBP (<130 mm Hg) and treatment with two or more blood pressure-lowering agents, resulting in a higher risk of mortality,” researchers noted.

The results provide a “cautionary note” requiring dedicated, controlled interventional studies, they said.

The risks of so-called “polypharmacy” have long been suspected as a leading cause of premature death among nursing home residents. A previous study in the American Journal of Geriatric Pharmacotherapy, for example, concluded that the prevalence of polypharmacy among nursing home residents was approximately 40%, significantly higher for females.