
When Your Meds Start Making You Sick
Brad Stanfield
18 oct 2025
Mindsip insights from this episode:
Accept higher blood pressure for safer management in frail elderly
A recent study found that reducing blood pressure medications in frail elderly patients didn't increase mortality, making a higher blood pressure of up to 140 acceptable.
Set lenient blood sugar targets for frail older adults with diabetes
For frail older individuals with type 2 diabetes, a more lenient blood sugar target (HbA1c of 8%) is safer, as aggressive control increases the risk of falls.
Add SGLT2 inhibitors to reduce health risks in diabetes and heart failure
For patients with both type 2 diabetes and heart failure, adding an SGLT2 inhibitor like Empagliflozin is strongly indicated to significantly reduce health risks.
Reduce unnecessary medications to lower mortality risk
In one study of nursing home residents, efforts to reduce unnecessary prescriptions slashed mortality risk by an impressive 26% and fall risks by 24%.
Reassess medication risks as you age to avoid 'poison'
As we get older, the risks from medications can start to outweigh the benefits, turning them into what the speaker calls 'poison'.
Address low sodium to reduce fall risk in elderly
Even mild hyponatremia (low sodium), often caused by combining blood pressure and antidepressant drugs, can increase the risk of falls in the elderly by 42%.
Reconsider aspirin use due to bleeding risks
For those who haven't had a heart attack, clinical guidelines now suggest aspirin's 43% higher risk of major bleeding outweighs its modest benefits.
Utilize multiple low-dose BP medications for better results
It is preferable to have several blood pressure medications at low doses rather than one at a high dose to achieve a greater effect with fewer side effects.
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