title: A multicenter, case-control study of the effects of antihypertensive therapy on orthostatic hypotension, postprandial hypotension, and falls in octo- and nonagenarians in residential care facilities.
abstract: BACKGROUND
  Orthostatic hypotension, postprandial hypotension, and falls are considered to be adverse drug reactions of antihypertensive therapy in older people with comorbidities. Concerns regarding these adverse events may limit the use of antihypertensive agents in this group of people.
  
  
  OBJECTIVE
  The aim of this study was to determine the relationship between antihypertensive therapy in octo- and nonagenarians and the risk for orthostatic hypotension, postprandial hypotension, and falls.
  
  
  METHODS
  This was a case-control study of octo- and nonagenarians living in residential care facilities who were receiving antihypertensive therapy and a control group who were not receiving antihypertensive therapy.
  
  
  RESULTS
  A total of 119 patients, 77 who were receiving regular antihypertensive therapy and 42 who were not taking any antihypertensive agents, were enrolled in the study. The prevalence of antihypertensive use, orthostatic hypotension, postprandial hypotension, and falls was high (65%, 29%, 57%, and 45%, respectively). There were no associations between antihypertensive therapy and orthostatic hypotension, postprandial hypotension, and falls. When individual classes of antihypertensive agents were examined, the only observed association was a negative association (ie, a protective effect) between potassium-sparing diuretics and falls (odds ratio, 0.2; 95% CI, 0.04-1.0).
  
  
  CONCLUSIONS
  Antihypertensive therapy was not associated with an increased risk for orthostatic hypotension, postprandial hypotension, or falls in this case-control study of octo- and nonagenarians living in residential care facilities.
authors.affiliation: Department of Geriatric Medicine, The Canberra Hospital, Woden, Australian Capital Territory, Australia.
authors.forename: Alex A
authors.initials: AA
authors.lastname: Fisher
authors.affiliation: National Ageing Research Institute, University of Melbourne, Parkville, Australia.
authors.forename: Allan J
authors.initials: AJ
authors.lastname: McLean
authors.affiliation: Department of Geriatric Medicine, The Canberra Hospital, Woden, Australian Capital Territory, Australia.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Davis
authors.affiliation: Centre for Education and Research on Ageing, Concord RG Hospital, Concord, Australia ; ANZAC Research Institute, University of Sydney, Sydney, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
keywords: antihypertensives; falls; older people; orthostatic hypotension; postprandial hypotension