Drug use and low blood pressure in the elderly: a study of data from the kungsholmen project

The aim of the present study was to examine the prevalence of low blood pressure in an older population with respect to medication with drugs with potential hypotensive effects. Data from the Kungsholmen Project was used, a population-based study of elderly people aged 75 years and over in Stockholm, Sweden. Among the 1810 participants, 1748 with documentation on blood pressure and drug use were included in the study. Low systolic blood pressure, defined as <125mm Hg, was found in 157 subjects. Low diastolic blood pressure, defined as <65mm Hg, was found in 124 subjects. The association between drug use and low blood pressure was examined for drugs with known potential hypotensive effects (sympatholytic drugs, diuretics, beta-receptor blocking drugs, calcium antagonists, angiotensin-converting enzyme inhibiting drugs, nitrates, antiparkinsonian drugs, neuroleptics, anxiolytics, sedatives-hypnotics and antidepressant drugs) in a logistic regression model controlling for the possible confounders age, gender, housing, dementia status, cardiovascular disease, body mass index and dehydration. The use of potassium-sparing diuretics, dopaminergic antiparkinsonian drugs and neuroleptics showed a significant association with low systolic blood pressure. Dopaminergic antiparkinsonian drugs were significantly associated with low diastolic blood pressure. This may imply a risk in the elderly, where some of these drugs are commonly used, considering results from previous studies suggesting that low blood pressure may cause, for example, falls and fractures, accelerated dementia, myocardial ischaemia, cerebral ischaemia, and increased mortality in this age group.