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Blood pressure drugs double the risk of bone fractures in older adults

Healthcare workers have urged for a greater duty of care with older adults who start taking common blood pressure medicines, with a new study highlighting that they’re more than twice as likely to experience fall-related fractures after commencing treatment.

We’ve all experienced an uneasy lightheaded moment when we stand up quickly, but for seniors new to blood pressure medication, the side-effect of dizzy spells has the potential to prove fatal without close monitoring. Almost half of hip fractures in older age will trigger a series of health issues that lead to early death within 12 months.

In a study of nearly 30,000 age-care residents, researchers found that common blood pressure medicines induce this sudden dizziness, caused by a temporary bout of low blood pressure, making people already vulnerable to having balance issues even more at risk of serious injury.

“Such patients require careful observation, particularly when treatment begins, and that’s not happening,” said Chintan Dave, said. “Caregivers think of blood pressure medication as very low risk, and that’s not true in this patient population.”

Assessing the data of 29,648 elderly patients in age-care facilities who suffered hip, pelvis, humerus, radius or ulna breaks within 30 days of starting medicine, the researchers found that, after adjusting for potential covariates, the 30-day risk of fracture after beginning blood pressure medication was 5.4 per 100 people per year. For those who were not on the medication, the risk less than halved to 2.2 people per year.

For those with dementia or high systolic blood pressure the risk was also elevated, but patients with no recent history of taking blood pressure medicine had the worst outcomes.

“Bone fractures often start nursing home patients on a downward spiral,” said Dave. “Roughly 40% of those who fracture a hip die within the next year, so it’s truly alarming to find that a class of medications used by 70% of all nursing home residents more than doubles the bone-fracture risk.”

While the study doesn’t discount the importance of potentially life-saving blood pressure medicines, the researchers say more attention needs to be paid to those who are just starting treatment for the first time or after a period being off the drugs. Intervening in a fall could also, ultimately, prove life-saving.

“Caregivers can’t strike this right balance of risk and reward if they don’t have accurate data about the risks,” Dave said. “I hope this study gives them information that helps them serve their patients better.”

Some 2.5 million Americans reside in age-care homes or assisted living facilities, and up to 50% will take a tumble in a given year. The researchers hope the study will highlight the need for better support to make sure adults vulnerable to injury can mitigate their risk.

The research was published in the Journal of the American Medical Association.

Source: Rutgers University via EurekAlert

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