Today’s Solutions: September 26, 2023

The algebra of risk vs. reward may not pay off for people over the age of 70 who take antihypertensive drugs to lower their blood pressure. While these drugs reduce the risk of suffering a heart attack or stroke, this benefit is balanced out by an increased risk of serious injury from falls.

Researchers from the Yale University School of Medicine followed nearly 5,000 older adults with high blood pressure for three years—85% of whom were taking an antihypertensive drug such as a diuretic or beta-blocker. During the follow-up period, 446 people suffered serious injuries from falls, such as a hip fracture or traumatic head injury, and the risk of fall-related injury was 30% to 40% higher for people who were taking an antihypertensive drug compared to people who weren’t.

Among people who had a previous history of falling, the risk was more than doubled. It isn’t clear why antihypertensives appear to increase the likelihood of having a fall, but it may be due to them making people less alert or more likely to experience dizziness upon standing up. These findings suggest that doctors and their elderly patients should use caution when considering whether or not to prescribe or continue an antihypertensive.

(Source: JAMA Internal Medicine, 2014; doi: 10.1001/jamainternmed.2013.14764.)

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