Elderly Fall Injuries Tied to Antihypertensives

Increased risk of serious fall injuries is particularly high in those with previous fall injuries.
Increased risk of serious fall injuries is particularly high in those with previous fall injuries.

Antihypertensive medications are associated with an increased risk of serious fall injuries in the elderly, particularly among those with previous fall injuries, according to a study published online ahead of print in JAMA Internal Medicine.

Mary E. Tinetti, MD, from the Yale School of Medicine in New Haven, Conn., analyzed data from a cohort of 4,961 community-living adults (aged older than 70 years) with hypertension participating in the Medicare Current Beneficiary Survey. Centers for Medicare & Medicaid Services claims data were used to determine serious fall injuries, including hip and other major fractures, traumatic brain injuries, and joint dislocations.

The researchers found that 14.1% received no antihypertensive medications; 54.6% received moderate-intensity antihypertensives; and 31.3% received high-intensity antihypertensives. Over three years of follow-up, 446 participants (9.0%) experienced serious fall injuries. In adjusted analyses, patients in the moderate-intensity and high-intensive groups had a 40% and 28% increased risk for a serious fall compared with nonusers. Difference in the risk across the groups did not reach statistical significance, but results were similar in apropensity score-matched subcohort.

"The potential harms versus benefits of antihypertensive medications should be weighed in deciding to continue treatment with antihypertensive medications in older adults with multiple chronic conditions," the authors concluded.

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