Antihypertensive Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study.
BACKGROUND
Despite wide-spread use of antihypertensives in older adults, the literature is unclear about their association with incident recurrent falls over time.


METHODS
Health, Aging and Body Composition study participants (n = 2,948) who were well functioning at baseline (1997) were followed to Year 7 (2004). The main outcome was recurrent falls (≥2) in the ensuing 12 months. Antihypertensive use was examined as: (a) any versus none, (b) long- versus short-term (≥2 vs <2 years), and by (c) summated standardized daily dose (SDD; 1 = maximum recommended daily dose for one antihypertensive), and (d) subclass.


RESULTS
Controlling for potential demographic, health status/behavior and access to care confounders, we found no increase in risk of recurrent falls in antihypertensive users compared to nonusers (adjusted odds ratio [AOR] = 1.13; 95% CI = 0.88-1.46), or those taking higher SDDs or for longer durations. Only those using a loop diuretic were found to have a modest increased risk of recurrent falls (AOR = 1.50; 95% CI = 1.11-2.03).


CONCLUSIONS
Antihypertensive use overall was not statistically significantly associated with recurrent falls after adjusting for important confounders. Loop diuretic use may be associated with recurrent falls and needs further study.
Department of Medicine (Geriatrics), zmarcum@uw.edu.
Zachary A
ZA
Marcum
Department of Medicine (Geriatrics), Department of Biostatistics.
Subashan
S
Perera
Department of Medicine (Geriatrics), Department of Epidemiology, and.
Anne B
AB
Newman
Department of Pharmacy and Therapeutics, University of Pittsburgh, Pennsylvania. Center for Health Equity Research, Veterans Affairs Pittsburgh Healthcare System, Pennsylvania.
Joshua M
JM
Thorpe
Center for Health Equity Research, Veterans Affairs Pittsburgh Healthcare System, Pennsylvania. Departments of Medicine (General Internal) and Psychiatry, University of Pittsburgh, Pennsylvania.
Galen E
GE
Switzer
School of Pharmacy, University of Washington, Seattle.
Shelly L
SL
Gray
Intramural Research Program, National Institute on Aging, Baltimore, Maryland.
Eleanor M
EM
Simonsick
North Florida/South Georgia Veterans Health System GRECC, Gainesville.
Ronald I
RI
Shorr
Division of General Internal Medicine, University of California at San Francisco.
Douglas C
DC
Bauer
Department of Health Policy and Management, University of Pittsburgh, Pennsylvania.
Nicholas G
NG
Castle
Department of Medicine (Geriatrics).
Stephanie A
SA
Studenski
Department of Medicine (Geriatrics), Department of Biostatistics, Department of Epidemiology, and Department of Pharmacy and Therapeutics, University of Pittsburgh, Pennsylvania. Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Pittsburgh Healthcare System, Pennsylvania.
Joseph T
JT
Hanlon
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
D000959:Antihypertensive Agents
Drug related; Epidemiology; Falls; Medication