Sleeping Pill Use Linked to Later Increase in BP Meds

Medscape
10 Apr, 2019 ,

According to a new study, use of sleep tablets especially in older hypertensive patients showed increase in the use of anti-hypertensives subsequently. These results are an important insight as a large amount of geriatric population suffers from hypertension as well as sleep related issues. 

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The use of sleeping tablets by older hypertensive patients was linked to a subsequent increase in use of antihypertensive medications in a new study.

"Previous studies have generally found associations of sleep characteristics with blood pressure and hypertension in middle-aged adults. However, these associations were absent or inconsistent among older subjects," senior author José Banegas, MD, Universidad Autónoma de Madrid, Spain, explained to Medscape Medical News.

"Our findings may be useful in practice, given that 1 in 5 older people in the present study increased their antihypertensive treatments during the follow-up, and it is known that the greater the number of medications patients take, the higher the risk of inappropriate medications, adverse reactions, and lower treatment adherence," he added.

The prospective cohort study was published online on March 25 in Geriatrics and Gerontology International.

The study involved 752 patients aged ≥60 years (average, 69 years; 49% men) participating in a seniors cohort. The patients were undergoing treatment for hypertension and were followed from 2008-2010 through 2012-2013.

Self‐reported sleep duration, sleep quality (usually having difficulty falling asleep or staying asleep), and sleeping pill use (the type of hypnotic used was not specified) were ascertained at baseline, and the change in the number of antihypertensive drugs prescribed by the end of follow-up was calculated.

Analyses were carried out with logistic regression and were adjusted for demographics, lifestyle, comorbidity, baseline number of antihypertensive drugs used, and hypertension control.

Results showed that the mean sleep duration was 6.9 hours per night. Poor sleep quality was reported by 37%, and 16.5% reported that they usually took sleeping pills. The mean number of antihypertensive drugs used was 1.8.

During the follow‐up period, 156 patients (20.7%) increased the number of antihypertensive drugs they were taking. No association was found between sleep duration or quality and the change in antihypertensive drug use.

However, usual sleeping pill consumption was associated with a higher risk of increasing the number of antihypertensive drugs (odds ratio, 1.85; P = .02). The association was seen regardless of sleep duration and quality, body mass index, diet, physical activity, and hypertension control.

The researchers suggest several possible explanations for this observation.

They point out that some hypnotic agents may induce atropine-related parasympathetic inhibition and tachycardia, as well as hypertension, and others may increase sleep-disordered breathing, which may be associated with hypertension and, in particular, with nocturnal hypertension in older patients.

Other potential reasons of the association include underlying sleep disturbances that were not examined in the study (eg, anxiety) and reduced physical activity because of sedation, Banegas added.