Which adverse effects are linked to cardiovascular medications in older adults?

• A. Increased appetite
• B. Hyperglycemia only
• C. Hearing loss
• D. Falls, decreased heart rate, hypotension, depression, hyperkalemia

Answer: (D)

Older adults are particularly vulnerable to adverse effects of cardiovascular medications because aging changes how drugs are processed and how the body responds, and because many meds are used together. The adverse effects listed—falls, decreased heart rate, hypotension, depression, and hyperkalemia—capture the kinds of problems these drugs can cause in the elderly.

Beta-blockers and certain calcium-channel blockers can slow the heart rate, which, in an older person, may lead to dizziness and faintness. Dizziness and orthostatic changes from blood pressure–lowering drugs increase the risk of falls. Some cardiovascular agents can cause lower blood pressure overall or pronounced orthostatic hypotension, especially when standing, which again raises fall risk. Medications that interfere with the renin-angiotensin-aldosterone system or are potassium-sparing diuretics can raise potassium levels, leading to hyperkalemia, a dangerous electrolyte disturbance in older adults with comorbid kidney function changes. Mood changes, including depression, can be seen with certain cardiovascular drugs in susceptible individuals.

In contrast, increased appetite or hyperglycemia-only are not typical hallmark adverse effects of standard cardiovascular therapies, and hearing loss is not a common consequence of these medications.