Rates of delirium associated with calcium channel Mockers compared to diuretics, renin-angiotensin system agents and beta-blockers: An electronic health records network study
Rates of delirium associated with calcium channel Mockers compared to diuretics, renin-angiotensin system agents and beta-blockers: An electronic health records network study
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DOI：
10.1177/0269881120936501
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发表时间：
2020-07-08
影响因子：
4.1
通讯作者：
Colbourne, Lucy
中科院分区：
文献类型：
--
作者：
Harrison, Paul J.;Luciano, Sierra;Colbourne, Lucy
Background: Antihypertensive drugs, especially calcium channel blockers, have been associated with differential rates of a number of neuropsychiatric outcomes. Delirium is commonly attributed to medication, including antihypertensive drugs, but delirium incidence has not been compared directly between antihypertensive drug classes.Methods: Using a federated electronic health records network of 25.5 million people aged 50 years or older, we measured rates of delirium over a two-year period in patients prescribed calcium channel blockers compared to the other main antihypertensive drug classes. Extensive propensity score matching was used to create cohorts matched for a range of demographic factors and delirium risk factors. Negative control outcomes were also measured.Results: Cohort sizes ranged from 54,000-577,000. Delirium was more common with calcium channel blockers than with renin-angiotensin system agents (similar to 40% higher) but less common than with beta-blockers (similar to 20% lower). These differences remained when patients with a range of other delirium risk factors were excluded, and they were not paralleled by the negative control outcomes. Comparisons between calcium channel blockers and diuretics produced inconclusive results.Conclusions: Calcium channel blockers are associated with higher rates of delirium than renin-angiotensin system agents, but tower rates compared to beta-blockers. The findings add to the list of factors which may be considered when choosing antihypertensive drug class.
