Antihypertensives Linked to Eczema in Elderly Patients

A study found that older persons taking hypertension medications should be closely watched and this potential taken into account when assessing for eczema due to a slight rise in eczematous dermatitis.

Atopic dermatitis, also known as atopic eczema, is becoming more common in older adults, according to research data analyst Morgan Ye, MPH, of the University of California, San Francisco’s department of medicine, and colleagues. Older persons’ clinical presentations, particularly those with late-onset diseases, might be ambiguous. A prominent reason of misdiagnosing atopic eczema in older persons is thought to be drug-induced eczematous dermatitis.

Using information from The Health Improvement Network cohort’s primary care electronic health records, researchers carried up a longitudinal cohort study involving patients 60 years of age and older who had never been prescribed an antihypertensive medication or been diagnosed with eczematous dermatitis.

Over a median of six years, 6.7% of the over 1.5 million individuals had eczematous dermatitis overall.

The incidence of eczematous dermatitis was 11 to 12 per 1,000 patient-years among individuals who were prescribed hypertension drugs during the research, while the incidence was nine per 1,000 patient-years among those who were not prescribed antihypertensive medications.

According to the study, an absolute rate of three instances per 1,000 patient years, based on a population of 14.5 million older individuals in the U.K., might mean that these medicines are responsible for about 43,500 new cases of eczematous dermatitis annually.

These patients had an elevated hazard rate of 29% (HR = 1.29; 95% CI, 1.26-1.31) according to an adjusted Cox proportional hazard model.

Using antihypertensive medication classes as a stratification tool, the prevalence of eczematous dermatitis was highest in those taking diuretic drugs (HR = 1.21; 95% CI, 1.19-1.24) and calcium channel blockers (HR = 1.16; 95% CI, 1.14-1.18), while it was lowest in those taking angiotensin-converting enzyme inhibitors (HR = 1.02; 95% CI, 1-1.04) and B-blockers (HR = 1.04; 95% CI, 1.02-1.06).

The authors stated, “Based on the currently available evidence, clinicians could consider switching treatment to a different class of antihypertensive, such as an ACE inhibitor, if a clinical workup does not identify another cause for the dermatitis and it is bothersome and does not respond to treatment.” “These data could be helpful to clinicians to guide clinical management when an older patient presents with eczematous dermatitis, even though additional research is needed to understand the mechanisms underlying the association of antihypertensive drug use and eczematous dermatitis.”

For more information: Antihypertensive Medications and Eczematous Dermatitis in Older Adults, JAMA Dermatology, https://jamanetwork.com/journals/jamadermatology/fullarticle/2819258