Blood pressure medication may cause serious falls for older people

Blood pressure pills may be doing more harm than good as they increase the risk of having falls, research has found.

A Yale School of Medicine study looked at the health records of nearly 5,000 people with high blood pressure aged over 70. Over a three-year period, researchers found that people who were taking medication for their condition were more likely to experience a serious injury, such as hip fractures or dislocations, in a fall.

Among the people who took part in the survey, 14 per cent took no blood pressure medication, 55 per cent took moderate blood pressure medication, and 31 per cent were on a high dose.

During the study period 446 people (9 per cent) experienced serious injuries from falls and 111 people (24.9 per cent) died as a result.

“Older patients and their clinicians need to weigh up 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," said lead author professor Mary Tinetti of Yale School of Medicine.

"Patients may find themselves in the tough position of either choosing to continue their blood pressure medication and risk side effects that could lead to life-altering falls, or discontinuing their medications and risk heart attacks and stroke.

"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.”

Those taking medicine for hypertension were 30 to 40 per cent more likely to have a fall and the risk was more than doubled for those who had suffered previous falls. “The morbidity and mortality associated with serious injuries such as hip fracture and head injury were comparable to those associated with cardiovascular events,” the report authors concluded.

Many people who suffer from hypertension require several types of drugs for their treatment, often a mix of beta-blockers, diuretics, alpha-blockers, ACE inhibitors or calcium channel blockers.

Fall-related injuries such as hip fractures and brain injuries are among the most common, disabling and expensive health conditions experienced by older adults.

Julie Ward, senior cardiac nurse at the British Heart Foundation, said: “As we get older our blood pressure naturally gets higher and many of us will need to take medication to keep this under control. This is important in preventing cardiovascular events like heart attacks and strokes.

“We may also have other health conditions in our older years that can make us frailer and more at risk of having a fall – sometimes with serious consequences.

“This study shows that some blood pressure medications have side effects that make the risk of falls higher and it highlights the importance of close monitoring of elderly people who are taking these medications.”

The research was published in JAMA international medicine.