New research shows that drugs used to control blood pressure in patients with hypertension may also boost the risk of fall injuries, raising the possibility that the common medication may come with an unexpected side-effect for older people.
According to Dr. Mary Tinetti, a researcher at Yale University and lead author of the study, experts have long assumed that this type of blood pressure medication is perfectly safe for all patients. But the new results suggest that a closer look may be necessary. "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," she explained.
The study, which is published in the journal JAMA Internal Medicine, surveyed 4,961 hypertension patients ages 70 and up. Fourteen percent took no blood pressure medication, 55 percent took moderate blood pressure medication, and 31 percent were on a high dose of medication. Over a follow-up period of three years, the researchers compared medication use to serious injuries like hip fractures and head injuries from falls among the participants.
The team found that, compared to older hypertension patients who didn’t take any blood pressure medication, those who did were 30 to 40 percent more likely to suffer a serious fall injury. For many patients and physicians, this illuminates a difficult quandary. "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," she explained. "Patients may find themselves in the tough position.”
Control Your Blood Pressure Without Falling Over
What, then, are older hypertension patients supposed to do? Are there ways out of this unwanted tradeoff? According to Tinetti, the very awareness of the correlation may be sufficient to lower the incidence of injury. If patients know that their balance may be thrown off by their medication, they may be more careful around low furniture, stairs, and other common traps.
With the new results in mind, doctors treating hypertension patients may also think twice before opting for pharmacological solutions. To be certain that drugs are necessary, a physician may measure blood pressure when the patient is lying down as well as when she is standing. “If the blood pressure falls standing up then pressure medications should be reduced,” Tinetti wrote in an email to Medical Daily. “We should always test blood pressure standing and treat standing blood pressure rather than sitting blood pressure as one way to reduce the likelihood of serious fall injuries with blood-pressure medications."