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Use of beta-blockers for uncomplicated hypertension in the elderly: a cause for concern

Journal of Human Hypertension volume 21, pages 271–275 (2007)Cite this article

Abstract

Beta-blockers are less beneficial than other antihypertensive drugs in the elderly with hypertension. All elderly patients in Ontario, Canada (population over 3.5 million elderly) without co-morbidities who were first treated for hypertension with a beta-blocker were studied in a retrospective population-based cohort study (1994–2002) to determine the characteristics of those prescribed beta-blockers. Of the 194 761 patients in our cohort, 25 485 (13%) were prescribed a beta-blocker as their first antihypertensive agent. On multivariate analysis, factors significantly associated with being prescribed a beta-blocker as first-line therapy included male sex (adjusted odds ratio (OR) 1.06 [95% CI 1.03–1.09] vs women), younger age (adjusted OR 1.67 [95% CI 1.55–1.79] for patients aged 66–69 vs those aged 85 or older), residence in a long-term care facility (adjusted OR 1.19 [95% CI 1.04–1.35] vs living in the community) and lower socioeconomic status (adjusted OR 1.07 [95% CI 1.02–1.12], for lowest quintile vs highest quintile). Patients with diabetes were substantially less likely to be prescribed beta-blockers (adjusted OR 0.42 [95% CI 0.40–0.44]). Greater efforts are required to educate physicians to select other drugs for initial therapy in older patients with uncomplicated hypertension.

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Acknowledgements

Financial disclosures: NC has been paid fees for speaking and for consulting by most pharmaceutical companies in Canada that produce trade medications to lower blood pressure. In addition, NC has received research funds from Pfizer Canada, Sanofi-Aventis, Servier and Bristol-Myers-Squibb for research on the epidemiology of hypertension. NC also chairs the steering committee and executive committee of the Canadian Hypertension Education Program (CHEP) as a volunteer. CHEP has a mandate to improve the treatment and control of hypertension in Canada. FM has received operating grant funding from Pfizer Canada for an ongoing trial co-funded by the Heart and Stroke Foundation of Canada and Pfizer Canada. ZC and KT have no potential conflicts of interest.

This research was supported by a Grant-in-Aid from the Heart and Stroke Foundation of Ontario. KT is supported by a Canadian Institutes of Health Research (CIHR) Short-Term Clinician Investigator Award. FM is supported by an Alberta Heritage Foundation for Medical Research Population Health Scholar Award, a CIHR New Investigator Award, and the University of Alberta/Merck Frosst/Aventis Chair in Patient Health Management. None of the funding agencies had input into the design, conduct, analysis or reporting of this study.

Author Contributions: KT, NC and FM contributed equally in study concept and design, KT and ZC acquired and analyzed the data, all four authors contributed to the interpretation of the data and KT, NC and FM prepared the manuscript. All four authors approved the final manuscript for submission.

Sponsors role: This research was conducted independently of all funders.

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Authors and Affiliations

  1. Institute for Clinical Evaluative Sciences, Toronto, Canada

    K Tu & Z Chen

  2. Toronto Western Hospital Family Medicine Centre, University Health Network, Toronto, Canada

    K Tu

  3. Department of Family and Community Medicine,

    K Tu

  4. University of Toronto, Toronto, Canada

    K Tu

  5. Departments of Medicine and Pharmacology and Therapeutics and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Toronto, Canada

    N R C Campbell

  6. Division of General Internal Medicine, University of Alberta, Edmonton, Toronto, Canada

    F A McAlister

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  1. K Tu
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  4. F A McAlister
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Correspondence to N R C Campbell.

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Tu, K., Campbell, N., Chen, Z. et al. Use of beta-blockers for uncomplicated hypertension in the elderly: a cause for concern. J Hum Hypertens 21, 271–275 (2007). https://doi.org/10.1038/sj.jhh.1002128

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