Popular blood pressure drug may increase bleeding risk, study finds

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A recent study published in JAMA highlights a potential risk for patients with atrial fibrillation, the most common type of irregular heart rhythm, who are taking a widely-used blood pressure medication. According to the research, these patients may face a higher risk of serious bleeding complications.

Atrial fibrillation, as noted by the American Heart Association, increases the risk of blood clots and stroke if not properly managed. To mitigate these risks, patients are often prescribed medications that prevent clotting and control heart rate.

However, the interaction between these medications, particularly how they are metabolized by different individuals, can significantly affect their safety and effectiveness.

Eli Zimmerman, MD, an associate professor in the Division of Stroke and Vascular Neurology at the Ken and Ruth Davee Department of Neurology and an associate dean for student affairs, co-authored the study.

He emphasized the importance of understanding genetic differences in medication metabolism, which can lead to adverse effects, especially when multiple drugs are used to treat conditions like atrial fibrillation.

The study focused on Medicare beneficiaries aged 65 and older who began treatment with the anticoagulants apixaban or rivaroxaban along with either diltiazem or metoprolol, two drugs used to lower heart rate, between 2012 and 2020.

The findings revealed that patients taking diltiazem were 20% more likely to be hospitalized or die from bleeding-related issues compared to those on other treatments.

Interestingly, the study did not find significant differences in the rates of stroke, systemic embolism, or other types of hemorrhaging between the different medication groups.

These results point to a critical issue: while medications like diltiazem may offer certain benefits over alternatives like metoprolol, they may also lead to higher risks of bleeding due to the way they interact with other medications and are processed by the body.

Going forward, Zimmerman and his research team plan to further explore why different patients react differently to the same medications.

One area of focus will be on whether monitoring drug levels could help mitigate the increased risk of bleeding, providing a safer approach to managing atrial fibrillation in vulnerable populations.

This could lead to more personalized treatment plans that consider individual metabolic responses to medication.

If you care about blood pressure, please read studies about unhealthy habits that could increase high blood pressure risk, and people with severe high blood pressure should reduce coffee intake.

For more information about blood pressure, please see recent studies that early time-restricted eating could help improve blood pressure, and results showing plant-based foods could benefit people with high blood pressure.

The research findings can be found in JAMA.

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