Salt Lake City, UT—Because increased variability in blood pressure is associated with higher mortality risks, a new study is urging prescribers to avoid two types of antihypertensives—alpha blockers and alpha 2 agonists.

Those types of blood pressure medications appear to increase variability in blood pressure measurements, according to a presentation at the recent American College of Cardiology Scientific Session in Orlando.

“This study helped us identify blood pressure medications that produce more consistent blood pressure and better mortality outcome data,” explained lead author Brian Clements, DO, an internal medicine physician with the Intermountain Medical Center Heart Institute.

“Those medications include ace inhibitors, angiotensin receptor blockers, calcium channel blockers, and thiazide diuretics. People who are on other types of blood pressure medications have an increased risk of death.”

For the study, researchers sought to identify links between the type of blood pressure medication patients were using and variations in their blood pressure readings. The goal was to determine if specific classes of medications reduced the visit-to-visit blood pressure variability.

To do that, they analyzed results from more than 10,500 patients with at least seven recorded blood pressure measurements between January 2007 and December 2011 over 5 years, looking at visit-to-visit office blood pressure variability (VVOBPV). During follow-up, 27.6% of the patients, with a mean age of 71.5 years, died.

“Use of beta blocker, central alpha 2 agonist, and aldosterone antagonist antihypertensive medications was associated with lower risk of mortality in the setting of elevated VVOBPV compared to patients not using those medications,” study authors conclude.

“Patients should know what their blood pressure is, and if it’s up and down all the time, the patient should work with their physician to explore options for the best blood pressure medications that will reduce variances,” Clements added. “Where possible, the two types of medications that show an increase in variances should be avoided.”

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