Report reveals that elderly people on anti-hypertensive medication are more likely to have a fall

Posted: 27/02/2014

A recent report from scientists at Yale University warns that millions of elderly people are putting themselves at greater risk of falls by taking anti-hypertensive pills, which lower blood pressure but can lead to side effects such as dizziness, excessive tiredness and blurred vision. This is a significant issue when set against the statistic that the majority of over-70s suffer from high blood pressure and nearly five million in the UK take medication for hypertension.

Yale University 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 study found that those taking high blood pressure pills were 30% to 40% more likely to have a fall and the risk more than doubled for those who had suffered previous falls.

Researchers followed nearly 5,000 over-70s for three years, all of whom were on varying doses of anti-hypertensive medication. During the study period, 9% experienced serious injuries from falls and almost 25% died as a result. Previous studies have shown that you would expect a similar number to die from heart attacks or strokes if they had not been treated with medication over the same period. This study is therefore calling into question whether the risks of such medication are outweighing the potential benefits, reports The Telegraph.

Lead report author, Prof Mary Tinetti of Yale School of Medicine, commented: “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".

The report concludes by commenting that: “the morbidity and mortality associated with serious injuries such as hip fracture and head injury were comparable to those associated with cardiovascular events.”

Blood pressure guidelines in the US are currently being changed because of concerns that the risks of medicating elderly people outweigh the benefits and the National Institute for Clinical Excellence (NICE) said it will consider revising British guidelines when they come up for review.

Commenting on this research, Lucie Prothero, associate in the clinical negligence team at Penningtons Manches, said: “Falls and fall-related injuries are a common and serious problem for older people in the UK and this research from the USA provides interesting food for thought in the debate about how to reduce falls amongst the elderly. We are dealing with an increasing number of cases and enquiries relating to elderly falls, either in the hospital or community setting. In many instances, the falls have been catastrophic or fatal. Where elderly people have fallen while under the care of hospitals or community carers, our work often includes representing families at inquests to try to get to the bottom of what happened and how the fall might have been prevented.

“As our population ages, the issue of falls will become more pressing. These findings provide evidence that high blood pressure tablets are associated with an increased risk of falls in older people. These can have a devastating impact on the individual and their loved ones, sometimes resulting in disabling hip fractures, brain injury and even death. The report suggests that clinicians should pay greater attention to falls risk in older patients with hypertension and the NICE Guidelines on the Assessment and Prevention of Falls in Older People already acknowledge the risk factor. It is clear that the risks of medicating elderly patients for hypertension needs to be measured carefully against the benefits. It is important that clinicians closely monitor elderly patients who are taking these medications so that their risk of falls is considered and, hopefully, reduced.”

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