Antihypertensive agents can raise risk of fall injuries in elderly

Blood pressure medications used by many older adults can increase the risk of serious fall injuries by 30% to 40%-injuries that have a similar effect on mortality and functional loss as the strokes and heart attacks the antihypertensive drugs are meant to prevent-according to a study in the Feb. 24 issue of JAMA Internal Medicine.

Yale School of Medicine researchers studied 4,961 patients older than aged 70 years with hypertension and examined the link between blood pressure medication use and serious injuries such as hip fractures and head injuries from falls. Among the patients, 14% took no blood pressure medications, 55% took moderate-intensity blood pressure medications, and 31% were on a high dose.

The research team found during a 3-year follow-up of these patients that the risk for serious injuries from falls was higher for patients who used blood pressure medication than for non-users, and even higher for patients who had experienced a previous fall injury.

“Although no single study can settle the question and we cannot exclude the possibility that factors other than the medications accounted for the increased risk of injury, these medications may be more harmful in some individuals than thought,” lead author Mary E. Tinetti, MD, the Gladys Philips Crofoot Professor of Medicine and Public Health and chief of the Section of Geriatrics at Yale School of Medicine, said in a press release.

Fall-related injuries such as hip fractures and brain injuries are among the most common, disabling, and expensive health conditions experienced by older adults. Falls account for 10% of emergency department visits and 6% of hospitalizations among those over age 65 years. Falls can also lead to functional decline, placement in a nursing home, restricted activity, and death.

“Older patients and their clinicians need to weigh the harms as well as the benefits in prescribing medications, particularly when the harms may be at least as serious as the diseases and events we hope the medications prevent,” said Dr Tinetti. “Patients may find themselves in the tough position of either choosing to continue their blood pressure medication and risk side effects that could lead to life-altering falls, or discontinuing their medications and risk heart attacks and stroke.”