A large cohort study published in JAMA Dermatology found that the use of antihypertensive medications was associated with a small increased risk of developing eczematous dermatitis in adults aged ≥ 60 years.

The study analyzed data from over 1.5 million older adults in the United Kingdom from January 1, 1994, to January 1, 2015.

The researchers found that the overall prevalence of eczematous dermatitis was 6.7% during a median follow-up of 6 years. Participants who received antihypertensive drugs had a 29% higher risk of developing eczematous dermatitis compared to those who did not take these medications. The risk was highest for diuretic drugs and calcium channel blockers, with a 16-21% increased risk, while angiotensin-converting enzyme (ACE) inhibitors and β-blockers had the lowest risk, with a 2-4% increase.

The study's lead author, Dr. Katrina Abuabara, noted that although the increased risk was small, the findings could be helpful for clinicians when managing older patients who present with eczematous dermatitis. She suggested that if no other cause for the dermatitis is identified and it does not respond to treatment, physicians could consider switching to a different class of antihypertensive medication, such as an ACE inhibitor.

The researchers noted that additional research is needed to understand the underlying mechanisms of this association and to confirm the findings. They also acknowledged several limitations of the study, including the lack of detailed data on dermatitis severity and resolution, as well as the limited generalizability of the results to populations outside the United Kingdom.

Key Points from the Study:

• Study Design: Longitudinal cohort study using data from The Health Improvement Network in the UK.
• Population: 1,561,358 older adults (mean age 67 years; 54% female).
• Incidence Rate: 12 per 1000 person-years among those receiving antihypertensive drugs vs. 9 per 1000 person-years among those not receiving the drugs.
• Hazard Ratios: Diuretic drugs (HR 1.21), calcium channel blockers (HR 1.16), ACE inhibitors (HR 1.02), β-blockers (HR 1.04).
• Absolute Impact: Potentially 43,500 new cases of eczematous dermatitis annually among older adults in the UK due to antihypertensive medications.

Study Limitations:

• Lack of data on dermatitis severity and resolution.
• Limited generalizability beyond the UK population.
• Potential confounding factors not fully accounted for, such as dietary habits and other comorbidities.

Implications for Clinical Practice:

• Clinicians should consider the potential link between antihypertensive medications and eczematous dermatitis when diagnosing and managing older patients.
• Switching antihypertensive drug classes may be considered if dermatitis is unresponsive to conventional treatments.

Full disclosures and author contributions can be found in the study.