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Member Research & Reports

Member Research & Reports

UAB Researchers Assess Risk of Serious Falls Associated with Antihypertensive Medications

Past research indicates an elevated risk of falling associated with antihypertensive medications, although no data is readily available regarding the short-term threat following commencement and escalation of treatment. Recently, the University of Alabama at Birmingham department of epidemiology’s Dr. Emily B. Levitan, associate professor (pictured); Ms. Luqin Deng and Ms. Lei Huang, statisticians; and Dr. Paul Muntner, professor and vice chair, teamed with lead author Dr. Daichi Shimbo, associate professor at Columbia University Medical Center; Dr. C. Barrett Bowling, assistant professor at Emory University; Dr. John J. Sim, at Kaiser Permanente; and Dr. Kristi Reynolds, associate director of epidemiologic research at Kaiser Permanente Research, in a case-crossover study of 90,127 Medicare beneficiaries (ages 65 and older) designed to examine serious injuries as a result of falls occurring between July 1, 2007, and December 31, 2012. Initiation of treatment was defined by a filled prescription (with no refills in the previous 12 months); intensification was defined as either supplementing with an additional antihypertensive or an increased dosage of the current medication.

[Photo: Dr. Emily B. Levitan]

The researchers documented that “exposures were ascertained for the 15 days before the fall (case period) and six 15-day earlier periods (control periods). Overall, 272; 1,508; and 3,113 Medicare beneficiaries initiated, added a new class of antihypertensive medication or titrated therapy within 15 days of their serious fall injury. The odds for a serious fall injury was increased during the 15 days after antihypertensive medication initiation (odds ratio, 1.36 [95 percent confidence interval, 1.19–1.55]), adding a new class (odds ratio, 1.16 [95 percent confidence interval, 1.10–1.23]), and titration [odds ratio, 1.13 [95 percent confidence interval, 1.08–1.18]). These associations were attenuated beyond 15 days.” They concluded that commencement and escalation of antihypertensive medication was linked with short- rather than long-term elevated risk of serious falls among older patients.

“Short-Term Risk of Serious Fall Injuries in Older Adults Initiating and Intensifying Treatment With Antihypertensive Medication” was published in April in Circulation: Cardiovascular Quality and Outcomes.

Journal article: