A study involving senior adults reveals that antihypertensive medications are associated with an increased risk of severe fall injuries in older adults. The increased risk of fall injuries in individuals taking antihypertensive medications who have already experienced a fall is more than twice as likely to experience a subsequent serious fall than those not taking drugs. The study focused on participants in the Medicare Current Beneficiary Survey from 2004 to 2007 who were older than 70 years, resided in a community living environment, and were designated as traditional Medicare beneficiaries.
A total of 4,961 participants with a claims-based diagnosis of hypertension were included with a mean age of 80.2 years. The group of participants was further divided into three subgroups: a no-hypertensive medication group; a moderate-intensity medication group; and a high-intensity medication group. The research team then tracked fall incidents for each participant, limiting their review to only serious falls. The results showed that 446 of 4,961 participants experienced a severe fall injury, with 111 of the subjects passing away during the follow-up period.
In addition, broken down by subgroup, serious falls were experienced by 52 participants in the no-medication group, 267 in the moderate-intensity group, and 127 in the high-intensity group. The research team looked further into the histories of the subgroups, finding that for those who had fallen in the prior year, risk of another fall more than doubled for the medication groups. Also, no particular class of antihypertensive medication was found to be more strongly associated with fall risk than another.
Mindy Renfro, PT, PhD, GCS, explains, “Fall risk is multifactorial, and polypharmacy use is high on the list of modifiable risk factors. Cardiovascular medications… are only surpassed by psychoactive medications in increased risk for falls in all adults—but even more so in older adults. As the profession of choice for falls prevention and management, we need to consider these risk factors.”
Anita Bemis-Dougherty, PT, DPT, MAS, says, “Informing patients of the potential risks of medications and monitoring the effects of the medication on functioning—not just the effect of the medication on the condition being treated—must be considered, particularly in the older adult population.”
[Source: JAMA Internal Medicine]