Patient harm from cardiovascular medications.

Patient harm from cardiovascular medications: Background: • Harm from medications can cause poor patient outcomes.• Certain medications have been identified as 'high risk' and are known to cause high rates of harm.• 'High risk' medications are included in medication guidelines used by health professionals.• Cardiovascular medications (e.g. blood pressure and cholesterol medications) are important and have many benefits.• Recent studies have found cardiovascular medications to cause high rates of harm.• Cardiovascular medication harm is often under-recognised in clinical practice.• Some guidelines do not consider cardiovascular medications to be 'high risk'.Method: • This review investigated the extent of harm caused by cardiovascular medications in adults across four healthcare settings:(1) at the time of hospital admission;(2) during hospital admission;(3) after hospital; and(4) readmission to hospital.• Harm caused by cardiovascular medications was ranked against other medication classes.• We investigated the type of cardiovascular medications to cause harm and the type of harm caused.Results: • Seventy-five studies were reviewed across 41 countries.• Cardiovascular medications were ranked within the top five medications to cause harm.• Cardiovascular medications were a leading cause of harm in each healthcare setting investigated.• Harm caused by cardiovascular medications was common in older adults (>65 years).• Cardiovascular medications often caused preventable harm.• Medications to treat high blood pressure and abnormal heart rhythms were the most common causes of harm.• We reported kidney injury, electrolyte changes and low blood pressure as common types of harm.Conclusion: • Increased focus on cardiovascular medications in clinical practice is needed.• Health professionals need to carefully prescribe and frequently review cardiovascular medications, especially in older adults.• Patient and health professional discussions should be based on both the benefits and harms of cardiovascular medications.• Cardiovascular medications should be included in all 'high risk' medication guidelines.