145 Antihypertensive Medications and Falls in the Older Person

• Published in: Age and ageing Vol. 48; no. Supplement_4; pp. iv34 - iv39
• Main Authors: Quah, Jing Yao, Nadarajah, Reena, Chong, Elizabeth Gar Mit, Razali, Rizah Mazzuin, Lee, Fatt Soon, Yau, Weng Keong
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 20-12-2019; Oxford Publishing Limited (England)
• Subjects: ACE inhibitors; Angiotensin-converting enzyme inhibitors; Antihypertensives; Beta blockers; Calcium; Calcium channel blockers; Diuretics; Drugs; Falls; Geriatrics; Hypertension; Movement disorders; Neurodegenerative diseases; Older people; Parkinson's disease; Recurrent; Risk assessment; Risk factors; Sociodemographics; medication; older; falls; antihypertensive
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afz164.145

Abstract
Background
There have always been concerns about the increased risk of falls in the older person taking antihypertensive medications. This retrospective study is aimed to determine whether different classes and number of antihypertensive medication used were associated with increased risk of falls in the older person.
Methods
Data was obtained from the geriatric clinic database in HKL from 2015-2018. The data for fallers were extracted from the Falls Clinic while data for the control group of non-fallers were extracted from the General Geriatric clinic. Socio-demographic details, types of falls, types of medications, and risk factors of falls were analysed.
Results
117 of the cases who were fallers and 39 cases of non-fallers were analysed. Univariate logistic regression revealed that age, Parkinson’s disease and hypertension to have significant association with falls. The fallers were then analysed to assess falls risk with the use of antihypertensive medications. Those on one anti-hypertensive medication had an increased risk of recurrent falls (AOR = 3.16; 95% CI: 1.47–6.82) compared to those without antihypertensive medications (AOR = 0.37; CI: 0.13-1.03) and those with two or more antihypertensive medications (AOR = 0.56; CI: 0.27-1.16). Multivariate logistic regression also revealed that the use of all antihypertensive classes were not associated with recurrent falls and injuries from falls. However, patients who were on diuretics had significant odds of admission for falls (AOR 3.05; 95% CI 1.14-8.21) compared to ACE inhibitors or angiotensin receptor blockers (AOR 0.88; CI 0.38-2.10), beta blockers (AOR 0.88; CI 0.35-2.24), calcium channel blockers (AOR 0.96; CI 0.42-2.23) or alpha blockers (AOR 0.41; CI 0.09-1.99).
Conclusion
Older person with advanced age and Parkinson’s disease should be screened for risk of falling. In addition, all older people on antihypertensive medications especially diuretics should also be monitored for increased risk of falls.