Allopurinol Initiation and Change in Blood Pressure in Older Adults With Hypertension

Hypertension is a key risk factor for cardiovascular disease, and new treatments are needed. Uric acid reduction lowers blood pressure(BP) in adolescents, suggesting a direct pathophysiological role in the development of hypertension. Whether the same relationship is present in older adults is unknown. We explored change in BP after allopurinolinitiation using data from the UK Clinical Practice ResearchDatalink. Data were extracted for patients with hypertension aged >65 years who were prescribed allopurinolwith pretreatment and during treatment BP readings. Data from comparable controls were extracted. The change in BP in patients with stable BP medication was the primary outcome and was compared between groups. Regression analysis was used to adjust for potential confounding factors, and a propensity-matched sample was generated. Three hundred sixty-five patients who received allopurinoland 6678 controls were included. BP fell in the allopurinolgroup compared with controls (between-group difference in systolic and diastolic BP: 2.1 mm Hg; 95% confidence interval, −0.6 to 4.8; and 1.7 mm Hg; 95% confidence interval, 0.4–3.1, respectively). Allopurinoluse was independently associated with a fall in both systolic and diastolic BP on regression analysis ( P