BP meds may put elderly at risk for serious fall injuries

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Older adults who take blood pressure (BP) medication may be at increased risk for serious fall-related injuries, researchers found, especially if they have previously suffered injuries in a fall.

In a study published online Feb. 24 in JAMA Internal Medicine, Mary E. Tinetti, MD, of Yale School of Medicine in New Haven, Conn., and colleagues enrolled participants in the Medicare Current Beneficiary Survey between 2004 and 2007 who were 70 years of age or older, lived in a community and were traditional Medicare beneficiaries. They included 4,961 patients diagnosed with hypertension and whose medication data were available.

The investigators followed up with the participants for three years through 2009. As outcomes, they looked at serious fall injuries, such as hip fractures, other major fractures, traumatic brain injuries and joint dislocations.

Among the participants, 54.6 percent were taking moderate-intensity antihypertensive medications, 31.3 percent were taking high-intensity antihypertensive medications and 14.1 percent were not taking any blood pressure medications. Over the three-year follow-up period, serious fall injuries occurred in 446 participants (9 percent).

Additional analysis determined a higher risk for serious fall injuries in the groups taking antihypertensives compared with the group not taking any (hazard ratio [HR] 1.4 in the moderate-intensity group and 1.28 in the high-intensity group), although these ratios were not statistically significant.

Of the participants who previously experienced a serious fall injury, the hazard ratios were 2.17 in the moderate-intensity group and 2.31 in the high-intensity group compared with the group not taking antihypertensives. There was no association between fall injury risk and class of antihypertensives.

Because of the substantial morbidity and mortality associated with serious fall injuries, the authors argued that the use of these medications should be weighed carefully in older adults.

“The potential harms vs. benefits of antihypertensive medications should be weighed in deciding to continue treatment with antihypertensive medications in older adults with multiple chronic conditions,” they wrote.