Harms of Continued Antihypertensives: An Overview of Reviews

Area of Science:

• Pharmacology
• Geriatrics
• Cardiovascular Medicine

Background:

• Hypertension is a major cardiovascular risk factor, with stricter blood pressure management recommended for older adults.
• Antihypertensive medications are crucial for managing hypertension and reducing cardiovascular morbidity.
• Evidence on specific harm outcomes of antihypertensive treatment is limited, posing challenges in clinical practice.

Purpose of the Study:

• To systematically review and summarize evidence on the harms associated with continued antihypertensive treatment.
• To focus on the older population to understand treatment-related risks in this demographic.

Main Methods:

• Conducted a comprehensive search of systematic reviews in Ovid MEDLINE, Ovid Embase, and the Cochrane Library.
• Included systematic reviews of randomized and non-randomized controlled trials on antihypertensive drug harms, excluding other article types.
• Focused the analysis on studies pertaining to the older population.

Main Results:

• The review identified 47 eligible systematic reviews from an initial search of 6353 items.
• Commonly reported side effects include respiratory symptoms (e.g., dry cough with ACE inhibitors), hypotension, renal failure, and electrolyte imbalances.
• These findings highlight a broad spectrum of potential adverse events associated with antihypertensive therapies.

Conclusions:

• Antihypertensive drugs are effective in managing hypertension and mitigating cardiovascular disease.
• Despite their benefits, a wide range of side effects necessitates careful patient monitoring and individualized treatment strategies.
• Further research into specific harm outcomes is warranted to optimize antihypertensive therapy, particularly in older adults.