Alpha blockers may contribute to increased hypotension risk
Use of alpha blockers in the treatment of hypertension in women is associated with an increased risk of hypotension and related events as compared with other blood pressure (BP)-lowering drugs, as reported in a recent study.
Researchers used data from a population-based, retrospective cohort study of 734,907 women (mean age, 75.7 years) in Ontario, Canada. They applied a high dimensional propensity score to assess the risk of hypotension and related adverse events with 14,106 alpha blocker users vs 14,106 patients dispensed other BP-lowering agents.
The primary outcome was a composite of hospitalizations for hypotension and related events (syncope, fractures and falls) within 1 year. The outcome occurred more frequently among alpha blocker users (1,214 events) than among users of other BP-lowering drugs (1,025 events), with crude incidence rates of 95.7 (95 percent CI, 90.4–101.1) and 79.8 (74.9–84.7) per 1,000 person-years, respectively.
When outcomes were analysed individually, the risk associated with alpha blockers was higher for hypotension (hazard ratio, 1.71, 1.33–2.20) and syncope (hazard ratio, 1.44, 1.18–1.75). Risk of falls, fractures, adverse cardiac events or all-cause mortality did not differ between alpha blockers and other BP-lowering drugs.
Alpha blockers are commonly prescribed as part of a multidrug regimen in the treatment of hypertension, according to the researchers. The present data suggest that these drugs should be used with caution, even as add-on therapy for elevated BP.