Their study found that patients aged over 70 had a 30% to 40% greater risk of fall injuries such as broken hips, joint dislocations and brain injuries if they took antihypertensives. The risk was more than twice as high among treated patients with a prior history of falls.
Experts said GPs should weigh up whether using BP drugs to lower the risk of MI and stroke outweighs the added risk of serious injury from a fall, which can be as harmful as a cardiovascular event.
Dizziness and light-headedness are common side effects of BP medication. But researchers said the low risk of fall injuries reported in previous trials in older adults may not reflect the risk in older adults with multiple chronic conditions.
To investigate, researchers from the Yale School of Medicine in Connecticut, US, looked at data from 4,961 patients over 70 with hypertension.
A third (31%) took high doses of BP drugs, 55% were on moderate doses and 14% took no BP medication.
Over three years, 446 patients (9%) had serious injuries from falls. Compared with those who did not take BP drugs, the risk of a serious injury was 40% higher among patients on moderate doses of BP drugs and 28% higher among those on higher doses.
Among patients with a serious injury from a fall within the past year, those on antihypertensives were up to 2.3 times more likely to experience a further injury over the following three years.
No particular class of antihypertensive increased the risk of fall injuries.
Researchers concluded: ‘The potential harms versus benefits of antihypertensive medications should be weighed in deciding whether to continue antihypertensives in older adults with multiple chronic conditions.’
In a commentary article, Sarah Berry and Douglas Kiel of Hebrew SeniorLife in Boston, Massachusetts, said clinicians should ‘pay greater attention to fall risk in older adults with hypertension in an effort to prevent injurious falls, particularly among adults with a previous injury’.