Harms of Continued Antihypertensives: An Overview of Reviews.

Abstract

Background: Antihypertensives are effective drugs for treatment of hypertension, which is one of the most important risk factors for cardiovascular morbidity. Intensive hypertension treatment significantly reduces cardiovascular risk among older people. Based on these findings, guidelines recommend stricter blood pressure management nowadays. Reasoning on benefit and harms of antihypertensive treatment can be challenging in daily practice because little evidence is available on specific harm outcomes.

Objective: With this overview of reviews, we aim to summarize evidence from systematic reviews on harms associated with continued antihypertensive treatment.

Methods: We searched Ovid MEDLINE, Ovid Embase and the Cochrane Library for systematic reviews with or without meta-analysis. Included were all systematic reviews of randomized and non-randomized controlled trials on harms of antihypertensive drugs in English. Any other type of article was excluded. Change in focused on the older population.

Results: The search resulted in 6353 items. A total of 105 articles were eligible for full-text screening, and 47 articles fulfilled eligible criteria and were included. Most common side effects included respiratory symptoms like dry cough (particularly under angiotensin-converting enzyme inhibitors), hypotensive symptoms, renal failure and electrolyte misbalances.

Conclusion: Antihypertensives have a broad spectrum of side effects, but they are effective drugs against hypertension and reduce cardiovascular disease burden.