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Osteoporosis International

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01-10-2013 | Original Article

The risk of falls on initiation of antihypertensive drugs in the elderly

Authors: D. A. Butt, M. Mamdani, P. C. Austin, K. Tu, T. Gomes, R. H. Glazier

Published in: Osteoporosis International | Issue 10/2013

Abstract

Summary

Antihypertensive drugs are associated with an immediate increased falls risk in elderly patients which was significant during the first 14 days after receiving a thiazide diuretic, angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker, calcium channel blocker, or beta-adrenergic blocker. Fall prevention strategies during this period may prevent fall-related injuries.

Introduction

The purpose of this study is to evaluate if initiation of the common antihypertensive drugs is associated with the occurrence of falls.

Methods

This population-based self-controlled case series study used healthcare administrative databases to identify new users of antihypertensive drugs in the elderly aged 66 and older living in Ontario, Canada who suffered a fall from April 1, 2000 to March 31, 2009. The risk period was the first 45 days following antihypertensive therapy initiation, further subdivided into 0–14 and 15–44 days with control periods before and after treatment in a 450-day observation period. We calculated the relative incidence (incidence rate ratio, IRR), defined as the rate of falls in the risk period compared to falls rate in the control periods.

Results

Of the 543,572 new users of antihypertensive drugs among community-dwelling elderly, 8,893 experienced an injurious fall that required hospital care during the observation period. New users had a 69 % increased risk of having an injurious fall during the first 45 days following antihypertensive treatment (IRR = 1.69; 95 % CI, 1.57–1.81). This finding was consistent for thiazide diuretics, angiotensin-converting enzyme inhibitors, calcium channel blockers, and beta-adrenergic blockers but not angiotensin II receptor antagonists. There was also an increased falls risk during the first 14 days of antihypertensive drug initiation (IRR = 1.94; 95 % CI, 1.75–2.16), which was consistent for all antihypertensive drug classes.

Conclusions

This study suggests that initiation of antihypertensive drugs is a risk factor for falls in the elderly. Fall prevention strategies during this period may reduce injuries.

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Title: The risk of falls on initiation of antihypertensive drugs in the elderly
Authors: D. A. Butt
M. Mamdani
P. C. Austin
K. Tu
T. Gomes
R. H. Glazier
Publication date: 01-10-2013
Publisher: Springer London
Published in: Osteoporosis International / Issue 10/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-013-2369-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The risk of falls on initiation of antihypertensive drugs in the elderly

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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