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Health See other Health Articles Title: Blood pressure meds may raise elderly fall risk NEW YORK (Reuters Health) - Older people who take blood pressure medications had more serious injuries from falls than those not taking medications, according to a new study. The added risk with blood pressure meds for falls that cause serious injury has been suggested before, but older people shouldn't stop taking their medications based just on these results, the authors say. "It is important to remember that no single study, and particularly an observational study such as ours, can give a definitive answer," said Dr. Mary E. Tinetti, who led the research. "We cannot say definitively that antihypertensive medications led to serious fall injuries such as hip fractures," said Tinetti, a geriatrics researcher at Yale School of Medicine in New Haven, Connecticut. Most people over 70 years of age have high blood pressure, or hypertension, which increases the risk for heart attacks and stroke. Currently, antihypertensive medications including diuretics like Tenoretic, beta blockers like Lopressor and ACE inhibitors, often taken together, are the best way of managing the health risks of high blood pressure. Among U.S. adults with high blood pressure in 2012, 83 percent were aware of their condition and 76 percent were taking medications to treat it, according to a Centers for Disease Control and Prevention Survey. For the new study, the researchers used existing, publicly available data on hospitalizations after a serious fall for almost 5,000 patients over 70 with hypertension. Based on the patients' dosing of high blood pressure drugs and the number of different drugs they were taking over the three-year study period, researchers divided them into three groups of medication "intensity." The patients' average age was 80 and 14 percent were taking no high blood pressure medications at all, while 55 percent were on a moderate-intensity regimen of blood pressure medications and 31 percent were on a high-intensity drug regimen. Among those taking medication, more than a third were on at least three different kinds of blood pressure drugs. Over the three years of the study, 446 patients suffered a serious injury, like hip fracture or head injury. Compared to the no-medication group, those in the moderate-intensity medication group were 1.4 times as likely to suffer a serious injury from a fall, and those in the high intensity group were 1.3 times as likely. Overall, however, the increased risk was still small, according to results in JAMA Internal Medicine. Of the 4,961 people included in the study, 52 (7.5 percent) in the no-medication group had a serious fall injury, compared to 267 (9.8 percent) in the moderate-intensity medication group and 127 (8.2 percent) in the high-intensity group. "Clinically, it is not uncommon for an older adult to say that they think their blood pressure medications are making them feel dizzy or weak or unsteady," Tinetti told Reuters Health in an email. The way this study was designed, it is difficult to identify other factors that could be influencing fall risk. It is possible, Tinetti said, that people who were at greater risk of fall injury to begin with were also at greater risk of being prescribed blood pressure medications, though even in a smaller group with similar medication users and non-users compared, the results remained the same. "Interestingly the authors did not find that any one class of medications was safer with respect to the risk of injurious falls, so much is unknown about the mechanism leading to injury," said Dr. Sarah D. Berry of the Institute for Aging Research at the Hebrew Rehabilitation Center in Boston. Berry authored a commentary published alongside the new study. Diuretics directly affect bone mineral density and could lead to an increased risk of fracture, Berry said. Other medications might cause dizziness or lightheadedness that accompanies drops in blood pressure and could lead to falls that way, she added. Determining which factor is more important, the risk of heart disease and stroke or fall injuries, will depend on the individual patient, Tinetti said - there appears to be a tradeoff between the two. "It is probably the case that some older adults are at greater risk of having a stroke and controlling their blood pressure is in their best interest," she said. "However, for others, the risk of a serious fall injury such as head injury or hip fracture may outweigh the benefit of blood pressure medications." Patients and their doctors should make treatment decisions on an individual basis, and doctors should remember to ask their patients what their priorities are as well, she said. SOURCE: http://bit.ly/NvtVOg JAMA Internal Medicine, online February 24, 2014. 15 Comments [Ron] I'm 77 years old and have tried different BP drugs. Most of them are too caustic for me but Amlodipine besylate seems to have no side effects. My BP without the drug runs around 210/110. I have always been an active individual running about 8 miles a day up to my 60th birthday. At 60 I had a triple by-pass and found running quite difficult until recently when I began running again on my treadmill. People my age generally do have High BP because of arterial hardening. I have discovered that a low sodium diet is very effective. I have also discovered that elderly individuals have a general deterioration of their balance mechanism, which has nothing to do with BP. There are medicines out there such as Doxazosin that can cause dizziness but eldery individuals generally do not have very good balance whether they take a medicine or not. If you are over thirty try closing your eyes and standing on one foot. Chances are you will find it quite difficult. If you are under thirty you might find it quite simple. Age and balance go hand in hand. Dr. Ron+3 [rita] I was on 3 meds for high bp. I fell twice, had never fallen before in my life. I am 78 yrs old and had a mild heart attack 12 yrs ago. Started feeling dizzy and weak. I would wake up an my bed was spinning. When I walked up the stairs I leaned on the wall to make it up without falling. I routinely checked my bp. It was running 90 over 64. I completely cut out one of my bp meds and immediately started feeling like my old self. No more dizziness, weakness and feel as sure footed as I did years ago. I had tests from cardiologist recently, my blood flow is great and both he and my primary care physician agree I'm in great shape. Never told either one of them I had discontinued one of medications. As long as I feel well who cares+6 [RON JUST ONE MORE INDICATION THAT LEGAL DRUGS USED AS THE DOCTOR ORDERS IS RESPONSIBLE FOR 225,000 DEATHS EACH YEAR. THERE ARE CURES FOR HIGH BLOOD PRESSURE IT IS A NUTRITION PROBLEM BUT SINCE THE QUACKS CALLED DOCTORS ARE NOT SCHOOLED IN NUTRITION BUT HEAVILY SCHOOLED IN DRUGS GUESS WHAT THEY DO. FACE FACT, DOCTORS ARE NOTHING MORE THAN DRUG SALESMEN FOR THE DRUG CARTELS KNOWN AS BIG PHARMA THE MOST LUCRATIVE CRIME ORGANIZATION IN THE HISTORY OF MANKIND. ONE OF THE MOST DANGEROUS THING A PERSON CAN DO IS WALK INTO THAT DOCTORS OFFICE AND LET THEM DESTROY YOUR HEALTH.+7 [frosty] It's important to know what your BP is in the middle of the night. I found that most of the time my BP is normal at night. I stopped taking all BP meds since I found that out. You can very easily drop to dangerously low BP if you aren't careful. BP will fluctuate during the day for me, but it always returns to the safe zone after moderate walking exercise. Less than 150 systolic is now the recommended limit for those over 65. It's crazy to aim for 110 as you age. You actually need slightly higher BP to ensure blood reaches your extremities. Many older people have cold feet, so the need for blood to get there, How about your brain? You certainly don't want to be less blood going there. Could be a cause of dementia with too low BP.+5 [James R] THE FALLS RESULTING IN BROKEN HIPS ARE PROBABLY CAUSED BY OSTEOPOROSIS AND NOT MEDICATION. THE HIP BREAKS AND THE PATIENT FALLS. WE HAVE KNOWN THIS SINCE THE 50'S. I AM 80 AND TAKE THREE ANTI HYPERTENSIVES AND WOULD RATHER RISK A FALL THAN EXPERIENCE A STROKE OR HEART ATTACK!!! [David] Be careful when first taking bp meds. My first prescription was for 10 mg. The first week, apparently, my pressure dropped too low and I passed out and fell face-first onto the floor. No serious damage but bloodied from breaking my glasses and had nasty bruises. After consulting with my doctor my scrip was lowered to 5 mg and no problems since. Message: start out with the smallest size and work yourself up.+3-1 http://news.yahoo.com/blood-pressure-meds-may-raise-elderly-fall-risk-162938728.html?soc_src=copy Post Comment Private Reply Ignore Thread Top • Page Up • Full Thread • Page Down • Bottom/Latest Begin Trace Mode for Comment # 1.
#1. To: Tatarewicz (#0)
These studies are a joke and a waste of money. I worked for a year in a nursing home in college. BP medications such as diuretics can make you light-headed, and when some get old they get thinner bones. So if they fall they break their hips. This has been known for 40 years at least.
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