– Blood pressure pills ‘raise risk of fatal fall’ (Telegraph, Feb 25, 2014):
Blood pressure pills may be doing more harm than good as they increase the risk of elderly people having falls, scientists have found
Millions of older people taking high-blood pressure tablets, like beta-blockers, may be doing themselves more harm than good because the pills increase the risk of fatal falls, scientists have warned.
Yale University has discovered that the risk of dying from a fall when taking tablets rises by 40 per cent over three years – similar to the risk of dying from a heart attack or stroke over the same period.
The majority of over 70s suffer from high blood pressure and nearly 5 million take medication for hypertension.
But several recent studies have questioned whether the risks and side-effects of medication are outweighing the benefits.
Hypertension drugs lower blood pressure but can lead to side-effects which include dizziness, excessive tiredness and blurred vision.
“Older patients and their clinicians need to weigh 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 Prof 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.”
Researchers followed nearly 5,000 over-70s for three years. Among the patients, 14 per cent took no blood pressure medication, 55 per cent took moderate blood pressure medications, and 31 per cent were on a high dose.
During the study period 446 patients (9 percent) experienced serious injuries from falls and 111 people (24.9 per cent) died as a result. Previous studies have shown that you would expected a similar number to die from heart attacks or strokes if they had not been treated with medication over the same period.
Those taking medicine for hypertension were 30 to 40 per cent more likely to have a fall and the risk 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.
Prof Sarah Berry of the Institute of Ageing in Boston said: “These findings add evidence that antihypertensive medications are associated with an elevated risk of injurious falls.
“Clinicians should pay greater attention to fall risk in older adults with hypertension in an effort to prevent injurious falls, particularly among adults with a previous injury.”
Blood pressure guidelines in the US are currently being changed because of concerns that the risks of medicating elderly people outweigh the benefits.
And they claim older people often suffer debilitating side-effects from being on a cocktail of drugs, which do not make them feel better.
Many people who suffer from hypertension require several types of drugs for their treatment, which could be a mix of beta-blockers, diuretics, alpha-blockers, ACE inhibitors or calcium channel blockers.
The National Institute for Clinical Excellence said it will consider revising British guidelines when they come up for review.
Fall-related injuries like hip fractures and brain injuries are among the most common, disabling and expensive health conditions experienced by older adults.
They account for 10 per cent of emergency department visits and 6 per cent of hospitalizations among those over age 65. Falls can also lead to functional decline, placement in a nursing home, restricted activity, and death.
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 medications 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 study was published in JAMA international medicine.