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The Study

Older Age, Polypharmacy, and Low Systolic Blood Pressure Are Associated With More Hypotension-Related Adverse Events in Patients With Type 2 Diabetes Treated With Antihypertensives

In simple terms

This study looked at a bunch of people with diabetes and noticed that those with lower blood pressure also tended to feel dizzy or faint more often. But it didn’t change anyone’s medicine to see if that caused the dizziness — it just watched what was already happening. So we can say low blood pressure is linked to dizziness, but we can’t say it’s the cause.

60%

Analysis score

60/ 72

Maximum 72 for a cohort study.

Where the score came from

Reporting40
Methodology38
Publication100
Statistical77
Study type (basis of the score)
Cohort Study
Level 2b - Individual cohort study
What’s the bottom line?

This study looked at older diabetic patients on blood pressure pills and found that when their blood pressure drops too low (under 130), they’re more likely to feel dizzy, faint, or weak.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Cohort Studies
Level 2b
60

60 / 100

Quality score

Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.

Cannot establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1Yes — even though low blood pressure is often targeted to prevent heart problems, this shows it can cause real, common side effects like fainting, especially in older or heavily medicated patients.
  2. 25.4% of patients had dizziness or fainting; 61% had blood pressure under 130; those with BP <130 had 41% more dizziness/fainting than those with higher BP; people over 70 had 29% more risk; those on 10+ pills had over double the risk.

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

Frontiers in Pharmacology

Year

2021

Authors

Martina Ambrož, Sieta T. de Vries, K. Hoogenberg, P. Denig

Open Access
7 citations
Analysis v6

Related Content

Claims (6)

Assertion

Frail adults over 80 with low systolic blood pressure (below 130 mm Hg) and taking multiple medications have a higher rate of death from any cause.

Correlational
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Assertion

Among patients with type 2 diabetes, those taking 10 or more medications are more than twice as likely to experience adverse events related to low blood pressure than those taking fewer than five medications, regardless of their systolic blood pressure readings.

Correlational
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Assertion

Among people with type 2 diabetes taking blood pressure medication, low systolic blood pressure does not lead to a higher or lower rate of hypotension-related adverse events when comparing different age groups, sexes, or numbers of medications taken.

Correlational
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Assertion

Among patients with type 2 diabetes taking blood pressure medications, those with systolic blood pressure below 130 mmHg experience 41% more hypotension-related adverse events such as dizziness, fainting, or weakness than those with systolic blood pressure at or above 130 mmHg.

Correlational
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Assertion

In patients with type 2 diabetes taking blood pressure medication, those aged 70 or older are 29% more likely to have adverse events caused by low blood pressure than those younger than 70, even when their systolic blood pressure readings are the same.

Quantitative
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Assertion

In people with type 2 diabetes who are taking blood pressure medication, 5.4% experience adverse events related to low blood pressure, most often postural hypotension, and 61% have a systolic blood pressure reading below 130 mmHg.

Descriptive
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