New research suggests that increased use of antihypertensive medications is associated with an increase in eczematous dermatitis.

Researchers conducted a longitudinal cohort study in a population-based sample from primary care practices in The Health Improvement Network in the United Kingdom. The sample included individuals aged 60 and older who were initially free of eczematous dermatitis, with the data covering the period from January 1, 1994, to January 1, 2015. Analyses were performed from January 6, 2020, to February 6, 2024. Exposure was defined by the first prescription of an antihypertensive drug within each class, and the main outcome of interest was the incidence of newly diagnosed eczematous dermatitis (identified using a validated algorithm).

Among the 1,561,358 participants (mean age 67 years; 54% female), the prevalence of eczematous dermatitis increased (6.7% over a median follow-up of 6 years). Incidence rates were higher in those taking antihypertensive drugs (12 per 1000 person-years) compared to those who were not (9 per 1000 person-years). Adjusted Cox proportional hazard models indicated a 29% increased hazard rate of developing eczematous dermatitis among those using any antihypertensive drugs (HR, 1.29; 95% CI, 1.26-1.31). When analyzed by drug class, diuretics (HR, 1.21; 95% CI, 1.19-1.24) and calcium channel blockers (HR, 1.16; 95% CI, 1.14-1.18) presented the highest risk. The smallest risk increase was linked to angiotensin-converting enzyme inhibitors (ACE inhibitors; HR, 1.02; 95% CI, 1.00-1.04) and β-blockers (HR, 1.04; 95% CI, 1.02-1.06).

"This cohort study found that antihypertensive drugs were associated with a small increased rate of eczematous dermatitis, with effect sizes largest for calcium channel blockers and diuretic drugs, and smallest for angiotensin-converting enzyme inhibitors and β-blockers," the authors wrote in *JAMA Dermatology*. "Although additional research is needed to understand the mechanisms underlying the association, these data could be helpful to clinicians to guide management when a patient presents with eczematous dermatitis in older age."

Source: Ye M, et al. *JAMA Dermatology*. 2024. doi:10.1001/jamadermatol.2024.1230