Journal article
Hypertension Treatment and Control and Risk of Falls in Older Women
Journal of the American Geriatrics Society (JAGS), Vol.67(4), pp.726-733
04/2019
DOI: 10.1111/jgs.15732
PMCID: PMC6458056
PMID: 30614525
Abstract
BACKGROUND/OBJECTIVES
A lower risk of falls is commonly cited as a reason to treat hypertension conservatively in older individuals. We examined the effect of hypertension treatment and control status and measured blood pressure (BP) level on the risk of falls in older women.
DESIGN/SETTING
Prospective cohort study.
PARTICIPANTS
A total of 5971 women (mean age 79 years; 50.4% white, 33.1% black, 16.5% Hispanic/Latina) enrolled in the Women's Health Initiative and Objective Physical Activity and Cardiovascular Health study.
MEASUREMENTS
BP was measured by trained nurses, and hypertension treatment was assessed by medication inventory. Participants mailed in monthly calendars to self‐report falls for 1 year.
RESULTS
Overall, 70% of women had hypertension at baseline (53% treated and controlled, 12% treated and uncontrolled, 5% untreated). There were 2582 women (43%) who reported falls in the 1 year of surveillance. Compared with nonhypertensive women, when adjusted for fall risk factors and lower limb physical function, the incidence rate ratio (IRR) for falls was 0.82 (confidence interval [CI] = 0.74‐0.92) in women with treated controlled hypertension (p = .0008) and 0.73 (CI = 0.62‐0.87) in women with treated uncontrolled hypertension (p = .0004). Neither measured systolic nor diastolic BP was associated with falls in the overall cohort. In women treated with antihypertensive medication, higher diastolic BP was associated with a lower risk of falls in a model adjusted for fall risk factors (IRR = 0.993 per mm Hg; 95% CI = 0.987‐1.000; p = .04). The only class of antihypertensive medication associated with an increased risk of falls compared with all other types of antihypertensive drugs was β‐blockers.
CONCLUSION
Women in this long‐term research study with treated hypertension had a lower risk of falls compared with nonhypertensive women. Diastolic BP (but not systolic BP) is weakly associated with fall risk in women on antihypertensive treatment (<1% decrease in risk per mm Hg increase). J Am Geriatr Soc, 2019. J Am Geriatr Soc 67:726–733, 2019.
Details
- Title: Subtitle
- Hypertension Treatment and Control and Risk of Falls in Older Women
- Creators
- Karen L. Margolis - HealthPartnersDavid M. Buchner - University of Illinois Urbana-ChampaignMichael J. LaMonte - University at Buffalo, State University of New YorkYuzheng Zhang - Fred Hutch Cancer CenterChongzhi Di - Fred Hutch Cancer CenterEileen Rillamas-Sun - Fred Hutch Cancer CenterJulie Hunt - Fred Hutch Cancer CenterFarha Ikramuddin - University of MinnesotaWenjun Li - University of Massachusetts Chan Medical SchoolSteve Marshall - University of North Carolina at Chapel HillDori Rosenberg - Kaiser Permanente Washington Health Research InstituteMarcia L. Stefanick - Stanford UniversityRobert Wallace - University of IowaAndrea Z. LaCroix - University of California San Diego
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.67(4), pp.726-733
- DOI
- 10.1111/jgs.15732
- PMID
- 30614525
- PMCID
- PMC6458056
- NLM abbreviation
- J Am Geriatr Soc
- ISSN
- 0002-8614
- eISSN
- 1532-5415
- Publisher
- John Wiley & Sons, Inc
- Number of pages
- 8
- Grant note
- National Institutes of Health U.S. Department of Health and Human Services (HHSN268201600018C; HHSN268201600001C; HHSN268201600002C; HHSN268201600003C; HHSN268201600004C) National Heart, Lung, and Blood Institute (R01HL105065)
- Language
- English
- Date published
- 04/2019
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984363585702771
Metrics
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