title: Use of beta-blockers for uncomplicated hypertension in the elderly: a cause for concern.
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.
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Tu
authors.forename: N R C
authors.initials: NR
authors.lastname: Campbell
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.forename: F A
authors.initials: FA
authors.lastname: McAlister
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D040561:Assisted Living Facilities; D015986:Confounding Factors, Epidemiologic; D004363:Drug Utilization / Q000639:trends; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D009864:Ontario / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D012107:Research Design; D012189:Retrospective Studies; D012737:Sex Factors; D012923:Social Class; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents