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Mirabegron-associated hypertension — SCE Geriatric Medicine MCQ

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ModerateContinenceMirabegron-associated hypertensionSCE Geriatric Medicine

An 82-year-old man with mild cognitive impairment is reviewed after starting mirabegron for overactive bladder. His urgency improved, but BP is now 176/92 mmHg on two readings; baseline was 132/76 mmHg. He has previous TIA and CKD3. What is the most appropriate management?

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Correct answer: B — Stop or review mirabegron and reassess bladder symptoms and blood pressure

Mirabegron can increase blood pressure and is unsuitable in severe uncontrolled hypertension. In an older patient with prior TIA and CKD, the new BP rise should prompt review or cessation and reassessment of continence options. Adding anticholinergic therapy may worsen cognition and retention risk. The pearl is that non-anticholinergic bladder medicines still require geriatric safety monitoring.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/neurological-conditions/dementia