Blood-Pressure Meds and Serious Falls

By Jane Farrell

Blood-pressure medications have an unintended and potentially deadly side effect: they increase the risk of serious fall injuries by up to 40 percent.

Yale School of Medicine researchers looked at 4,961 patients older than 70 who had hypertension. Among the participants, 14 percent didn’t take any medication, 55 percent took moderate doses and 31 percent took high doses.

After a three-year follow-up, the investigators found that the risk of serious injuries from falls was higher among patients who used blood pressure medications than those who didn’t. The difference was even more marked when comparing patients who had a previous fall injury.

The findings were published in JAMA Internal Medicine.

“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,” said lead author Dr. Mary E. Tinetti, the Gladys Philips Crofoot Professor of Medicine and Public Health and chief of the Section of Geriatrics at Yale School of Medicine.

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

Physicians have long assumed that blood-pressure medication is safe for all older adults. The researchers said that may be true for older adults who are otherwise healthy, but might not benefit people with other chronic conditions.

 “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 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.”