A new study published in the journal JAMA is raising concerns about certain medications taken by people with atrial fibrillation (AFib), a common type of irregular heartbeat.
The research found that some blood pressure drugs, when taken with blood thinners, may increase the risk of serious bleeding.
AFib is a condition where the heart beats irregularly. It can lead to blood clots and strokes if not treated properly. To prevent this, doctors often prescribe blood thinners (also called anticoagulants) to reduce the risk of clots, along with drugs that help control the heart rate.
But managing AFib can be tricky. Many people with the condition, especially older adults, take multiple medications. These drugs can interact with each other and sometimes cause harmful side effects. How a person’s body processes these medications can vary based on their genes, making it even more complicated.
In this study, researchers looked at the health records of people aged 65 and older who were on Medicare. These patients started taking blood thinners like apixaban or rivaroxaban between 2012 and 2020. At the same time, they were also taking heart rate control medications, either diltiazem or metoprolol.
The main finding was that those who took diltiazem had a 20% higher risk of being hospitalized or dying from bleeding problems than those who took other medications. This may be because diltiazem can interact with blood thinners and make the blood too thin, leading to bleeding.
Interestingly, the risk of stroke or clot-related problems was not much different between the groups. That means while diltiazem may help control heart rate, it could also come with a bigger risk of bleeding.
This is especially important for older adults, who are more likely to have AFib and to be sensitive to side effects from medications. The study shows the need to carefully weigh the benefits and risks of different drug combinations.
Dr. Eli Zimmerman, one of the study’s authors, said that one possible solution could be to monitor drug levels in a patient’s blood more closely.
This might help doctors adjust the doses or choose different medications, so people get the benefits without the extra risks. The goal is to create a more personalized treatment plan for each patient.
The study also reminds us that lifestyle choices matter. For example, drinking too much coffee can raise blood pressure, especially in people who already have high levels. But healthy habits like eating more plant-based foods or following time-restricted eating plans may help lower blood pressure.
This research is another step toward safer and more effective treatment for people with atrial fibrillation. It shows that while medications can help, they must be used carefully—especially when combined with other drugs. Patients and doctors need to work together to find the best and safest treatment approach.
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