Rates of delirium associated with calcium channel blockers compared to diuretics, renin-angiotensin system agents, and beta-blockers: an electronic health records network study

Journal article

Background: Antihypertensive drugs (AHTs), especially calcium channel blockers (CCBs), have been associated with differential rates of a number of neuropsychiatric outcomes. Delirium is commonly attributed to medication, including AHTs, but delirium incidence has not been compared directly between AHT classes.

Methods: Using a federated electronic health records network of 25.5 million people aged 50 years or older, we measured rates of delirium over a 2-year period in patients prescribed CCBs compared to the other main AHT classes. Extensive propensity score matching was used to create cohorts matched for a range of demographic factors and delirium risk factors. Negative control outcomes were also measured.

Results: Cohort sizes ranged from 54,000 to 577,000. Delirium was more common with CCBs than with renin-angiotensin system (RAS) agents (~40% higher) but less common than with beta-blockers (~20% lower). These differences remained when patients with a range of other delirium risk factors were excluded, and they were not paralleled by the negative control outcomes. Comparisons between CCBs and diuretics produced inconclusive results.

Conclusions: CCBs are associated with higher rates of delirium than RAS agents, but lower rates compared to beta-blockers. The findings add to the list of factors which may be considered when choosing AHT class.

Authors: Harrison, P; Luciano, S; Colbourne, L

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: SAGE Publications
• Journal: Journal of Psychopharmacology
• Volume: 34
• Issue: 8
• Pages: 848-855
• Publication date: 2020-07-08
• Acceptance date: 2020-05-28
• DOI: 10.1177/0269881120936501
• EISSN: 1461-7285
• ISSN: 0269-8811
• Language: English
• Keywords: FFR