A new study published in JAMA has found that a common blood pressure medicine might raise the risk of serious bleeding in people with atrial fibrillation (AFib), a condition where the heart beats irregularly.
AFib is the most common type of irregular heartbeat. It can cause blood clots and increase the chance of stroke if not treated. To help prevent this, doctors often give patients medicines that thin the blood and help control the heart’s rhythm.
But people’s bodies don’t all respond to medicine the same way. Some people process drugs differently because of their genes. This can cause unexpected problems, especially when they are taking more than one medication at a time.
Dr. Eli Zimmerman, a professor at Northwestern University and one of the study authors, explained that it’s very important to understand how different people react to medicines—especially when dealing with complex conditions like AFib.
If doctors don’t consider these differences, patients could face serious health risks without knowing it.
The study focused on people 65 and older who were on Medicare. These patients started taking two common blood thinners—apixaban or rivaroxaban—along with either diltiazem or metoprolol, which are both used to slow the heart rate. The researchers studied patients who began these treatments between 2012 and 2020.
The findings showed that people who took diltiazem were about 20% more likely to be hospitalized or die due to serious bleeding, compared to those who took metoprolol. However, there were no big differences between the groups when it came to strokes, blood clots, or other kinds of bleeding.
This means that while diltiazem may help control heart rate, it might also raise the risk of dangerous bleeding when used with some blood thinners. This could be because the drugs interact in a way that makes it harder for the body to handle them safely.
The study shows the need for more personalized treatment plans. Dr. Zimmerman and his team want to learn more about why some people are more affected than others. They are also looking into whether tracking drug levels in the blood could help reduce bleeding risks.
If this works, it could make it safer to treat AFib, especially in older people who are more at risk.
Managing heart health is not just about taking pills. Lifestyle habits and diet matter too. For example, people with very high blood pressure may want to limit their coffee. Eating earlier in the day—called early time-restricted eating—has also been linked to lower blood pressure. Plant-based diets can help, too.
This new study shows how complex heart treatment can be. Some drugs that help with one problem might cause another.
Doctors should look closely at how each patient’s body reacts to medications. Patients should stay informed and talk to their doctors about what’s safest for them.
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