Hypertension Treatment and Falls: Should We be Concerned?

Berlowitz, Dan R.

doi:10.1007/s11606-014-3016-5

Cited by 5 publications

(8 citation statements)

References 13 publications

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“…It has been shown that uncontrolled blood pressure increases the risk of immediate standing balance impairment. Some studies showed the effect of a drop in blood pressure on increasing the rate of falls [36][37][38][39]. Our study revealed that SBP (including treated or untreated status) is inversely associated with falling.…”

Section: Discussionsupporting

confidence: 51%

The association of cardio-metabolic risk factors and history of falling in men with osteosarcopenia: a cross-sectional analysis of Bushehr Elderly Health (BEH) program

et al. 2022

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Background Osteosarcopenia, defined as sarcopenia plus osteopenia/osteoporosis, may increase the risk of fractures and affects morbidity and mortality in the older population. Falling is also common in the elderly and increases the risk of fractures and mortality. We examined the association of cardio-metabolic risk factors with a history of falling in osteosarcopenic men. Methods We used the baseline data of the Bushehr Elderly Health (BEH) program. Osteosarcopenia was defined as having both sarcopenia (reduced skeletal muscle mass plus low physical performance and/or low muscle strength) and osteopenia/osteoporosis (T-score ≤ − 1.0). Falling was defined as a self-reported history of an unintentional down on the ground during the previous year before the study. We used logistic regression analysis to estimate the adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) to quantify the associations. Results All elderly men diagnosed with osteosarcopenia (n = 341), with a mean age of 73.3(±7.4) years, were included. Almost 50(14.7%) participants reported falling. Age showed a positive association with falling (AOR: 1.09, 95%CI: 1.04–1.14). An increase of 10 mmHg in systolic blood pressure(SBP), reduces the odds of falling by 26%(AOR:0.74, 95%CI:0.62–0.89), while a positive association was detected for fasting plasma glucose (FPG), as 10 mg/dl increase in the FPG, raises the chance of falling by 14%(AOR = 1.14, 95%CI:1.06,1.23). Hypertriglyceridemia was inversely associated with falling (AOR = 0.33, 95% CI: 0.12, 0.89). Conclusions Falling is a major public health problem in rapidly aging countries, especially in individuals with a higher risk of fragility fractures. Older age-raised fasting plasma glucose and low SBP are associated with falling in osteosarcopenic patients. Considering the higher risk of fracture in osteosarcopenic men, comprehensive strategies are needed to prevent fall-related injuries in this high-risk population.

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Section: Discussionsupporting

confidence: 51%

The association of cardio-metabolic risk factors and history of falling in men with osteosarcopenia: a cross-sectional analysis of Bushehr Elderly Health (BEH) program

et al. 2022

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“…Thus, adults with type 2 diabetes mellitus have an increased risk of falls [17]; however, the factors that determine this relationship are not yet known. We can also find evidence that problems related to blood pressure could lead to falls [18,23].…”

Section: Introductionmentioning

confidence: 75%

“…In overweight or obese people who suffer a same-level fall, the impact force is greater; therefore, the consequence of a fall will be proportionally higher [22]. On the other hand, cognitive impairment, even mild, and sensory conditions, such as cataracts, significantly increase morbidity in older adults [23]. More than one-third of adults over 65 years of age suffer cataracts annually, causing 1 in 10 falls with serious injuries [18].…”

Section: Introductionmentioning

confidence: 99%

Association of benzodiazepines, opioids and tricyclic antidepressants use and falls in trauma patients: Conditional effect of age

et al. 2020

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“…While many studies have demonstrated the benefits of antihypertensive agents on myocardial infarction and stroke risk reduction, 1–3 concerns have been raised regarding the risk of falls associated with antihypertensive medications among older adults. 4 5 Growing evidence suggests that the associated risk of injurious falls varies according to the duration of treatment. 5 6 Studies have consistently shown that older adults are at a greater risk for injurious falls or hip fractures shortly after initiating antihypertensive medications.…”

Section: Introductionmentioning

confidence: 99%

Association between gaps in antihypertensive medication adherence and injurious falls in older community-dwelling adults: a prospective cohort study

et al. 2019

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ObjectiveGrowing evidence suggests that older adults are at an increased risk of injurious falls when initiating antihypertensive medication, while the evidence regarding long-term use of antihypertensive medication and the risk of falling is mixed. However, long-term users who stop and start these medications may have a similar risk of falling to initial users of antihypertensive medication. Our aim was to evaluate the association between gaps in antihypertensive medication adherence and injurious falls in older (≥65 years) community-dwelling, long-term (≥≥1 year) antihypertensive users.DesignProspective cohort study.SettingIrish Community Pharmacy.ParticipantsConsecutive participants presenting a prescription for antihypertensive medication to 106 community pharmacies nationwide, community-dwelling, ≥65 years, with no evidence of cognitive impairment, taking antihypertensive medication for ≥1 year (n=938).MeasuresGaps in antihypertensive medication adherence were evaluated from linked dispensing records as the number of 5-day gaps between sequential supplies over the 12-month period prior to baseline. Injurious falls during follow-up were recorded via questionnaire during structured telephone interviews at 12 months.ResultsAt 12 months, 8.1% (n=76) of participants reported an injurious fall requiring medical attention. The mean number of 5-day gaps in medication refill behaviour was 1.47 (SD 1.58). In adjusted, modified Poisson models, 5-day medication refill gaps at baseline were associated with a higher risk of an injurious fall during follow-up (aRR 1.18, 95% CI 1.02 to 1.37, p=0.024).ConclusionEach 5-day gap in antihypertensive refill adherence increased the risk of self-reported injurious falls by 18%. Gaps in antihypertensive adherence may be a marker for increased risk of injurious falls. It is unknown whether adherence-interventions will reduce subsequent risk. This finding is hypothesis generating and should be replicated in similar populations.

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Hypertension Treatment and Falls: Should We be Concerned?

Cited by 5 publications

References 13 publications

The association of cardio-metabolic risk factors and history of falling in men with osteosarcopenia: a cross-sectional analysis of Bushehr Elderly Health (BEH) program

The association of cardio-metabolic risk factors and history of falling in men with osteosarcopenia: a cross-sectional analysis of Bushehr Elderly Health (BEH) program

Association of benzodiazepines, opioids and tricyclic antidepressants use and falls in trauma patients: Conditional effect of age

Association between gaps in antihypertensive medication adherence and injurious falls in older community-dwelling adults: a prospective cohort study

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