Characterising older adults' risk of harm from blood-pressure lowering medications: a sub-analysis from the PRIME study

Hussain, A S, Ali, K, Parekh, N, Stevenson, J M, Davies, J G, Bremner, S, Rajkumar, C and PRIME study group, (2022) Characterising older adults' risk of harm from blood-pressure lowering medications: a sub-analysis from the PRIME study. BGS Autumn Meeting 2021, Online, 24th - 26th November 2021. Published in: Age and Ageing. 51 (ISup_1) i1-i1. Oxford University Press ISSN 0002-0729

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Hypertension is a major risk factor for cardiovascular disease and death. Randomised trials in older adults with relatively few co-morbidities recommend treatment of their hypertension [1]. However, blood-pressure lowering medications increase the risk of medication-related harm (MRH) from adverse drug reactions (ADRs), non-adherence, medication errors and drug–drug interactions. We aimed to identify characteristics associated with MRH in older people on blood-pressure lowering medications.

The PRIME (prospective study to develop a model to stratify the risk of MRH in hospitalized elderly patients in the UK) study investigating the incidence and cost of MRH in 1280 older people in Southern England [2]. Adults ≥65 years were recruited from five teaching hospitals at hospital discharge and followed up for 8-weeks. Telephone interviews with study participants, review of primary care records and hospital readmissions were undertaken to identify MRH. PRIME study participants taking blood-pressure lowering medications, as defined by National Institute for Health and Care Excellence hypertension guidelines [3], were included in this analysis.

Sixty-six percent of the PRIME cohort (n = 841) were taking blood-pressure lowering medications. Patients on four blood-pressure lowering medications were five times more likely to experience MRH compared to those taking just one medication (OR 4.96; 95%CI 1.63-15.13;p = 0.01). Most harm events were serious (80%,n = 123), requiring dose change or treatment cessation. Most MRH cases were potentially preventable (49%,n = 75).

MRH from blood-pressure lowering medication in older people is common, serious, and potentially preventable. Decisions around maximising cardiovascular risk reduction must be carefully considered in the context of MRH from blood-pressure lowering medications.

Item Type: Conference Proceedings
Additional Information: The full article can be found here -
Keywords: cardiovascular disease, frailty, hypertension, medication-related harm, older people, polypharmacy, Aged, Antihypertensive Agents, Blood Pressure, Drug-Related Side Effects and Adverse Reactions, Humans, Patient Discharge, Prospective Studies
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Brighton and Sussex Medical School > Primary Care and Public Health
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 26 Apr 2022 07:06
Last Modified: 12 May 2022 07:52

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