DRUG-USE AND LOW BLOOD-PRESSURE IN THE ELDERLY - A STUDY OF DATA FROMTHE KUNGSHOLMEN PROJECT

The aim of the present study was to examine the prevalence of low bloo d pressure in an older population with respect to medication with drug s with potential hypotensive effects. Data from the Kungsholmen Projec t was used, a population-based study of elderly people aged 75 years a nd over in Stockholm, Sweden. Among the 1810 participants, 1748 with d ocumentation on blood pressure and drug use were included in the study . Low systolic blood pressure, defined as <125mm Hg, was found in 157 subjects. Low diastolic blood pressure, defined as <65mm Hg, was found in 124 subjects. The association between drug use and low blood press ure was examined for drugs with known potential hypotensive effects (s ympatholytic drugs, diuretics, beta-receptor blocking drugs, calcium a ntagonists, angiotensin-converting enzyme inhibiting drugs, nitrates, antiparkinsonian drugs, neuroleptics, anxiolytics, sedatives-hypnotics and antidepressant drugs) in a logistic regression model controlling for the possible confounders age, fender, housing, dementia status, ca rdiovascular disease, body mass index and dehydration. The use of pota ssium-sparing diuretics, dopaminergic antiparkinsonian drugs and neuro leptics showed a significant association with low systolic blood press ure. Dopaminergic antiparkinsonian drugs were significantly associated with low diastolic blood pressure. This may imply a risk in the elder ly, where some of these drugs are commonly used, considering results f rom previous studies suggesting that low blood pressure may cause, for example, falls and fractures, accelerated dementia, myocardial ischae mia: cerebral ischaemia, and increased mortality in this age group.