title: Association between antihypertensive medication use and non-cardiovascular outcomes in older men.
abstract: BACKGROUND
  Antihypertensive drugs are prescribed commonly in older adults for their beneficial cardiovascular and cerebrovascular effects, but few studies have assessed antihypertensive drugs' adverse effects on non-cardiovascular outcomes in routine clinical practice.
  
  
  OBJECTIVE
  To evaluate, among older adults, the association between antihypertensive medication use and physical performance, cognition, and mood.
  
  
  METHODS
  Prospective cohort study in a Veterans Affairs primary care clinic, with patients enrolled in 2000-2001 and assessed for medication use, comorbidities, health behaviors, and other characteristics; and followed-up 1 year later.
  
  
  METHODS
  544 community-dwelling hypertensive men over age 65 years.
  
  
  METHODS
  Timed chair stands; Trail Making Test part B; and Centers for Epidemiologic Studies Depression (CES-D) scores.
  
  
  RESULTS
  Participants had a mean age of 74.4 +/- 5.2 years and took a mean of 2.3 +/- 1.2 antihypertensive medications at baseline. After adjustment for age, comorbidities, level of blood pressure, and other confounders, each 1-unit increase in antihypertensive medication "intensity" was associated with a 0.11-second (95% confidence interval, 0.05-0.16) increase in the time required to complete the timed chair stands. No significant relationship was found between antihypertensive medication intensity and outcomes for Trail Making B or CES-D scores.
  
  
  CONCLUSIONS
  A higher cumulative exposure to antihypertensive medications in community-living older men was associated with adverse effects on physical performance, but not on the cognitive or depression measures available in this study. Clinicians should consider non-cardiovascular related adverse effects when treating older males taking multiple antihypertensive medications.
authors: Clinical Epidemiology Research Center 151B, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, USA. joseph.agostini@yale.edu
authors: Joseph V
authors: JV
authors: Agostini
authors: Mary E
authors: ME
authors: Tinetti
authors: Ling
authors: L
authors: Han
authors: Peter
authors: P
authors: Peduzzi
authors: Joanne M
authors: JM
authors: Foody
authors: John
authors: J
authors: Concato
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects*; D015897:Comorbidity; D003863:Depression / Q000139:chemically induced*; D004359:Drug Therapy, Combination; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents