12 • Probe •Vol LXII • No. 4 • Sep–Dec 2023 DRUG ALERT Hyperuricemia, Gout, and Related Adverse Events AssociatedWith Antihypertensive Drugs The objective of this study was to comprehensively evaluate the association between various antihypertensive drugs and the occurrences of hyperuricemia, gout, and related adverse events (AEs), using the FDA Adverse Event Reporting System (FAERS). Open Vigil 2.1 was used to query the FAERS database. Hyperuricemia, gout, and related AEs were defined by 5 preferred terms: hyperuricemia, gout, gouty arthritis, gouty tophus, and urate nephropathy. Disproportionality analysis was performed, and a positive signal indicated an association between AEs and antihypertensive drugs. The numbers of antihypertensive drugs with positive signals for hyperuricemia, gout, gouty arthritis, gouty tophus, and urate nephropathy were 46, 66, 27, 8, and 6, respectively. These drugs included diuretics, antihypertensive drugs with central action, α-blockers, β-blockers, α- and β-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, renin inhibitors, vasodilators, and compound preparations. Furthermore, 42 antihypertensive drugs had positive signals for more than 1 AE. The study suggests that some potassium-sparing diuretics, calcium channel blockers, and losartan may be associated with an increased risk of hyperuricemia, gout, or related AEs, which is inconsistent with most previous studies. Moreover, the study also suggests that some antihypertensive drugs with central action, α- and β-blockers, renin inhibitors, and vasodilators may be associated with an increased risk of hyperuricemia, gout, or related AEs, which has not been reported in previous studies. These findings complement real-world evidence on the potential risks of hyperuricemia, gout, and related AEs associated with antihypertensive drugs. Source: Jiao XF, et al. Front Pharmacol. 2023;13:1045561. Increased Risk of Heart Failure in Elderly Patients TreatedWith BetaBlockers After AV Node Ablation Indication of b-blockers (BBs) in different scenarios in patients with cardiovascular disease is controversial. This study was conducted to evaluate the effect of BBs on survival and heart failure (HF) hospitalizations in a sample of pacemaker-dependent patients after AV node ablation to control ventricular rate for atrial tachyarrhythmias. This retrospective study included consecutive patients who underwent AV node ablation and was conducted in a single center between 2011 and 2019. The study’s primary end points were the incidence of all-cause mortality, first HF hospitalization, and the cumulative incidence of subsequent hospitalizations for HF. Competing risk analyses were employed. A total of 111 patients with a mean age of 73.9 years were included in the study, of which 74 patients (66.7%) were on BBs, and the remaining 37 patients (33.3%) were not on BB treatment. After a median follow-up of 45.5 months, 43 patients had died (38.7%), and 31 had been hospitalized for HF (27.9%). The recurrent HF hospitalization rate was 74/1000 patients/year. Patients treated with BBs had a nonsignificant trend toward higher mortality rates and a higher risk of recurrent HF hospitalizations (incidence rate ratio, 2.23; 95% confidence interval, 1.12–4.44; P = .023). These results demonstrated that after an AV node ablation, the use of BBs is associated with an increased risk of HF hospitalizations in a cohort of elderly patients. Source: Bertomeu-Gonzalez V, et al. Am J Cardiovasc Drugs. 2023;23(2):157–164.
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