EFFECT OF ANTIHYPERTENSIVE USE ON FALL RISK
Author(s)
Blessing E. Alabi, B.Pharm1, Cole Chapman, PhD2;
1University of Iowa, College of Pharmacy, Iowa city, IA, USA, 2University of Iowa, Iowa City, IA, USA
1University of Iowa, College of Pharmacy, Iowa city, IA, USA, 2University of Iowa, Iowa City, IA, USA
OBJECTIVES: Unintentional falls cause significant morbidity among geriatrics. Anti-hypertensive therapy may increase fall risk by decreasing cerebral perfusion which can result in dizziness and syncope. The objective of this study is to determine the effect of anti-hypertensives on unintentional falls.
METHODS: This retrospective observational cohort study used data from electronic health records. The cohort consisted of two groups of patients with elevated blood pressure readings within 2015-2022: (1) patients with at least one outpatient-type anti-hypertensive prescription (aHTNrx) within 2016-2020 (exposed group), and (2) patients without aHTNrx but with at least one outpatient-type visit within 2016-2020 (comparison group). An index date, date of aHTNrx or outpatient-type visit, was identified for each patient. Patients were excluded if they had any aHTNrx 27months before index, or had no outpatient-type visit 2years pre-index, or had no clinic encounter within 2years post-index. We further stratified the cohort into 18-44years, 45-64years, 65+ years; and identified unintentional falls within 2years pre-index, and 2years post-index. We estimated the impact of anti-hypertensives on fall risk within age-strata using the Difference-in-Differences (DiD) method in a Logistic regression model. We adjusted for age, sex and number of comorbidities.
RESULTS: The final cohort had 2,197 and 48,771 patients in exposed and comparison groups respectively. Pre-index fall rates in exposed vs comparison groups were 3.3% vs 2.2%, 3.0% vs 3.0%, and 3.7% vs 4.0% for 18-44years, 45-64years, and 65+ years groups respectively; and 3.5% vs 1.8%, 4.0% vs 2.5%, 7.6% vs 5.2% in post-period. Covariates-adjusted DiD Odds Ratios and confidence intervals were 1.33 (0.68-2.59), 1.64 (0.95-2.87), and 1.70 (1.06-2.80) for the respective age-strata. Across age-strata, anti-hypertensives was associated with increased odds of falls among older adults (65+ years).
CONCLUSIONS: Our findings suggest anti-hypertensive use may elevate fall risk among older adults. Fall risk should therefore be considered in setting blood pressure targets in hypertension treatment in them.
METHODS: This retrospective observational cohort study used data from electronic health records. The cohort consisted of two groups of patients with elevated blood pressure readings within 2015-2022: (1) patients with at least one outpatient-type anti-hypertensive prescription (aHTNrx) within 2016-2020 (exposed group), and (2) patients without aHTNrx but with at least one outpatient-type visit within 2016-2020 (comparison group). An index date, date of aHTNrx or outpatient-type visit, was identified for each patient. Patients were excluded if they had any aHTNrx 27months before index, or had no outpatient-type visit 2years pre-index, or had no clinic encounter within 2years post-index. We further stratified the cohort into 18-44years, 45-64years, 65+ years; and identified unintentional falls within 2years pre-index, and 2years post-index. We estimated the impact of anti-hypertensives on fall risk within age-strata using the Difference-in-Differences (DiD) method in a Logistic regression model. We adjusted for age, sex and number of comorbidities.
RESULTS: The final cohort had 2,197 and 48,771 patients in exposed and comparison groups respectively. Pre-index fall rates in exposed vs comparison groups were 3.3% vs 2.2%, 3.0% vs 3.0%, and 3.7% vs 4.0% for 18-44years, 45-64years, and 65+ years groups respectively; and 3.5% vs 1.8%, 4.0% vs 2.5%, 7.6% vs 5.2% in post-period. Covariates-adjusted DiD Odds Ratios and confidence intervals were 1.33 (0.68-2.59), 1.64 (0.95-2.87), and 1.70 (1.06-2.80) for the respective age-strata. Across age-strata, anti-hypertensives was associated with increased odds of falls among older adults (65+ years).
CONCLUSIONS: Our findings suggest anti-hypertensive use may elevate fall risk among older adults. Fall risk should therefore be considered in setting blood pressure targets in hypertension treatment in them.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO124
Topic
Clinical Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)