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Blood Pressure Meds May Increase Fall Risk in the Elderly — Physician’s First Watch

Medical News |
February 25, 2014

Blood Pressure Meds May Increase Fall Risk in the Elderly

By Amy Orciari Herman

Use of antihypertensive medications may put elderly patients at increased risk for falls, according to a study in JAMA Internal Medicine.

Researchers studied nearly 5000 community-dwelling Medicare beneficiaries over age 70 with hypertension. During 3 years' follow-up, 9% had a serious fall injury. After multivariable adjustment, use of moderate-intensity antihypertensives was associated with a significant 40% increased risk for serious fall injuries relative to no antihypertensive use. High-intensity medications conferred a 28% increased risk, although this did not achieve statistical significance.

Neither the class nor number of antihypertensives was associated with increased risk. A history of fall injury in the previous year, however, seemed to strengthen the association between falls and antihypertensive treatment.

Commentators speculate on potential mechanisms and then conclude, "Clinicians should pay greater attention to fall risk in older adults with hypertension in an effort to prevent injurious falls, particularly among adults with a previous injury.

Reader Comments (2)

Sue Rushfirth Other Healthcare Professional, Home Care agencies

I absolutely agree with Dr Duarte. I am a physical therapist working in the field of home care and have requested that the therapy staff always take BP in sitting and standing. Although this is only anecdotal I am struck by the significant numbers of patients who do experience orthostasis. It also noteworthy that few of these patients are checked for this (in that they are not asked to stand) during the BP checks at the MD office and are generally unaware of the problem.
At the very least our staffs are able to teach some strategies for managing this possible drop in BP particular at night when our patients might otherwise be tempted to move too fast from lying to standing and when so many falls occur.

LUIS DUARTE Physician, Surgery, General, private office

if the antihypertensive treatment or medication isn;t associated with the falls in the elderly, I think probably the orthostatic hypotension might be the cause of this falls injuries.We must review the dosis?

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