Changes to BP Medication Could Raise Risk for Fall Injuries

Adding to or adjusting antihypertensive medication increases the risk of a fall injury in older patients for up to 15 days, according to a recent study.

Previous research has suggested an association between antihypertensive medication and the risk of falls. In the new study, the researchers investigated whether the adverse effects associated with initiation and intensification of antihypertensive medication—including problems with balance and walking, dizziness, and electrolyte abnormalities—could worsen the risk of falls.
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The researchers examined the emergency department and inpatient claims of 90,127 Medicare beneficiaries, aged 65 years and older, who had had a serious fall injury between July 1, 2007, and December 31, 2012.

The researchers defined initiation as a prescription fill with no fills in the previous year, intensification as the addition of a new antihypertensive class, and, separately, titration as the addition of a new class or increase in dosage of a current class.

Overall, 272 adults initiated therapy, 1508 intensified therapy, and 3113 titrated within 15 days of their fall injury. During those 15 days after medication adjustment, patients who initiated therapy had a 36% increased risk of falling, those who intensified their medication had a 16% increased risk, and those who titrated had a 13% increased risk.

However, beyond 15 days, the risk decreased significantly.

“Antihypertensive medication initiation and intensification was associated with a short-term, but not long-term, increased risk of serious fall injuries among older adults,” the researchers concluded.

—Amanda Balbi

Reference:

Shimbo D, Bowling CB, Levitan EB, et al. Short-term risk of serious fall injuries in older adults initiating and intensifying treatment with antihypertensive medication [published online May 10, 2016]. Circulation. doi:10.1161/CIRCOUTCOMES.115.002524.