A new study published in JAMA has found that older adults with atrial fibrillation, a common type of irregular heartbeat, may face a higher risk of serious bleeding if they take a widely-used blood pressure medicine.
Atrial fibrillation increases the risk of blood clots and stroke, so patients are often given blood thinners and medications to control their heart rate.
This study looked at how certain medications interact with each other, especially when used together. Some people process medications differently due to genetic differences, which can change how well the drugs work or increase the risk of side effects.
Dr. Eli Zimmerman, a professor and co-author of the study, explained that understanding how people’s bodies break down medications is very important. It can help avoid problems, especially when someone takes several drugs for a condition like atrial fibrillation.
The study focused on people aged 65 and older who were using two types of blood thinners—apixaban or rivaroxaban—along with either diltiazem or metoprolol, two drugs used to slow the heart rate. These patients were part of Medicare and were studied between 2012 and 2020.
The researchers found that patients taking diltiazem were 20% more likely to be hospitalized or die from bleeding problems than those who took metoprolol. However, there were no big differences in the number of strokes, blood clots, or other types of bleeding between the two groups.
This means that while diltiazem might help some patients, it could also raise the risk of dangerous bleeding, possibly because of how it interacts with other medications and how it’s processed in the body.
The research team plans to study more about why people react differently to the same medications. One idea is to check drug levels in the body during treatment to help lower the chance of bleeding. This could lead to more personalized care, where doctors choose the best medications based on how each person’s body works.
This study is a reminder of how important it is to carefully choose and monitor medications, especially in older adults with multiple health problems. It also shows that talking to your doctor and having regular check-ups are key to staying safe when taking multiple medications.
For people who care about blood pressure, it may also help to learn about habits that can raise blood pressure, such as drinking too much coffee. Other studies show that eating earlier in the day and eating more plant-based foods may help improve blood pressure.
If you care about heart health, please read studies about how drinking milk affects risks of heart disease , and herbal supplements could harm your heart rhythm.
For more information about heart health, please see recent studies about how espresso coffee affects your cholesterol level, and results showing Vitamin K2 could help reduce heart disease risk.
The full study is available in JAMA.
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