A recent study published in JAMA has raised concerns about the use of common blood pressure medications among individuals with irregular heart rhythms. Specifically, individuals with atrial fibrillation, the most prevalent form of irregular heart rhythm, face increased risks of serious bleeding when taking certain medications, according to study findings.
Anticoagulants and atrial fibrillation meds impact clotting
Atrial fibrillation poses significant health risks, including the potential for blood clots and strokes if left untreated, as highlighted by the American Heart Association. To manage these risks, healthcare providers often prescribe anticoagulant medications alongside drugs that regulate heart rate. However, study co-author Eli Zimmerman, MD, explains that genetic variations affecting medication metabolism can amplify these risks.
Dr. Zimmerman, an associate professor at the Ken and Ruth Davee Department of Neurology, emphasized the importance of understanding how genetic differences influence medication effectiveness and safety. He said that researchers have studies how the differences can have negative impacts with variations in drug metabolism expected to lead to unforeseen complications.
The study analyzed health records from Medicare beneficiaries aged 65 and older who were diagnosed with atrial fibrillation between 2012 and 2020. Researchers focused on individuals starting anticoagulant therapy with apixaban or rivaroxaban in combination with diltiazem or metoprolol, medications that lower heart rate.
Patients on diltiazem plus anticoagulants at increased risk of bleeding
According to the findings, patients taking diltiazem alongside anticoagulants were 20% more likely to experience bleeding-related hospitalizations and deaths compared to those taking metoprolol. The risks were found to increase with higher doses of medications. Importantly, the study did not observe significant differences in rates of stroke, systemic embolism, or hemorrhaging between the medication groups.
Zimmerman emphasized the importance of cautious medication prescribing for atrial fibrillation patients. He called for research into why people react differently to drugs and proposed better methods for monitoring drug levels in the future
The study’s findings provide valuable insights into the potential risks associated with commonly prescribed medications in this patient population. Moving forward, ongoing research efforts aim to refine treatment strategies and enhance patient safety by addressing individual variability in drug metabolism.
