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Beta‐blockers are associated with increased risk of first cardiovascular events in non‐diabetic hypertensive elderly patients
Author(s) -
Brouwers Frederieke M.,
Courteau Josiane,
Cohen Alan A.,
Farand Paul,
Cloutier Lyne,
Asghari Shabnam,
Vanasse Alain
Publication year - 2014
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3675
Subject(s) - medicine , diabetes mellitus , odds ratio , comorbidity , disease , medical prescription , cohort , adverse effect , pharmacoepidemiology , cohort study , antihypertensive drug , blood pressure , endocrinology , pharmacology
Purpose Although treatment should be considered for elderly patients with hypertension (HTN), the effectiveness of beta‐blockers (BBs) compared with other medications is less clear. This study's objective is to assess the relative effectiveness of BBs in elderly primary prevention patients with uncomplicated HTN. Methods This is a population‐based nested case‐control study. The cohort is composed of 94 844 elderly patients followed through 2009 and diagnosed with HTN between 2000 and 2004, without recent antecedents of diabetes, renal disease, or cardiovascular disease (CVD). Individuals with a CVD outcome were considered cases, and controls were matched to cases according to age, sex, date of cohort entry, and comorbidity index. Patients whose treatment included a BB were compared with patients on other HTN drug(s). Results The BB use by patients was associated with an increased risk for CVD events (odds ratio (OR) = 1.36, 95%CI: 1.31–1.40) compared with patients using antihypertensive therapies without BBs. Sensitivity analyses suggest that this increased risk is not due to differences in prescription patterns on the basis of perceived disease severity. Conclusions In real‐world settings, antihypertensive therapies that include BBs are associated with less effective prevention of adverse outcomes in elderly hypertensive patients in primary prevention compared with antihypertensive therapies without BBs. Pending further studies, we recommend caution when prescribing BBs in primary prevention except when otherwise indicated. Copyright © 2014 John Wiley & Sons, Ltd.