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Use of calcium antagonists and hemoglobin loss in hospitalized elderly patients: A cohort study
Author(s) -
Zuccalà Giuseppe,
Pedone Claudio,
Cocchi Alberto,
Pahor Marco,
Carosella Luciana,
Carbonin Pierugo,
Bernabei Roberto
Publication year - 2000
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1067/mcp.2000.104787
Subject(s) - medicine , odds ratio , hemoglobin , confidence interval , confounding , calcium , cohort , cohort study , anemia , gastrointestinal bleeding , logistic regression , gastroenterology
Objective To assess the association between in‐hospital use of calcium antagonists and incident reduction in hemoglobin levels, as well as the impact of individual baseline risk for gastrointestinal bleeding on such an association. Methods The association between calcium antagonists and hemoglobin decrease >1.2 g/dL was examined in 6721 patients enrolled in a collaborative pharmacoepidemiology study who did not take calcium antagonists before admission and with baseline hemoglobin ≥12 g/dL. Among these participants, 1076 patients started taking calcium antagonists during their hospital stays. Demographic variables, comorbid conditions, medications, and objective tests that were associated with incident hemoglobin loss in separate age‐ and sex‐adjusted logistic regression models were examined as potential confounders in a summary model. Higher risk for gastrointestinal bleeding was defined by diagnosis, treatment for peptic disease, or both. Results Hemoglobin decrease was detected in 24% of participants who started treatment with calcium antagonists and in 19% of other patients ( P < .0001). In addition, use of calcium antagonists was independently associated with increased probability of hemoglobin loss (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.03 to 1.45; P = .018) after adjusting for potential confounders. Treatment with calcium antagonists was associated with hemoglobin loss in patients with higher baseline risk for gastrointestinal bleeding (OR, 1.67; 95% CI, 1.26 to 2.22; P < .0001) but not among other participants (OR, 1.02; 95% CI, 0.82 to 1.25). Conclusion Starting treatment with calcium antagonists is associated with a reduction in hemoglobin levels during a hospital stay. However, the increased risk of hemoglobin loss seems to be limited to patients with diagnosis or symptoms of peptic disease. (Clin Pharmacol Ther 2000;67:314–22.) Clinical Pharmacology & Therapeutics (2000) 67 , 314–322; doi: 10.1067/mcp.2000.104787