Use of calcium antagonists and hemoglobin loss in hospitalized elderly patients: A cohort study

Objective: To assess the association between in-hospital use of calcium ant agonists and incident reduction in hemoglobin levels, as well as the impact of individual baseline risk for gastrointestinal bleeding on such an assoc iation. Methods: The association between calcium antagonists and hemoglobin decreas e >1.2 g/dL was examined in 6721 patients enrolled in a collaborative pharm acoepidemiology study who did not. take calcium antagonists before admissio n and with baseline hemoglobin greater than or equal to 12 g/dL, Among thes e participants, 1076 patients started taking calcium antagonists during the ir hospital stays, Demographic variables, comorbid conditions, medications, and objective tests that were associated with incident hemoglobin loss in separate age-and sex-adjusted logistic regression models were examined as p otential confounders in a summary model, Higher risk for gastrointestinal b leeding was defined by diagnosis, treatment for peptic disease, or both, Results: Hemoglobin decrease was detected in 24% of participants who starte d treatment with calcium antagonists and in 19% of other patients (P < .000 1), In addition, use of calcium antagonists was independently associated wi th increased probability of hemoglobin loss (odds ratio [OR], 1.22; 95% con fidence interval [CI], 1.03 to 1.45; P = .018) after adjusting for potentia l confounders, Treatment with calcium antagonists was associated with hemog lobin. loss in patients with higher baseline risk far gastrointestinal blee ding (OR 1.67; 95% CI, 1.26 to 2.22; P < .0001) bur not among other partici pants (OR, 1.02; 95% CI, 0.82 to 1,25), Conclusion: Starting treatment with calcium antagonists is associated with a reduction in hemoglobin levels during a hospital stay, However, the incre ased risk of hemoglobin loss seems to be limited to patients with diagnosis or symptoms of peptic disease.