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    Hypertension Treatment and Control and Risk of Falls in Older Women

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    Authors
    Margolis, Karen L.
    Buchner, David M.
    LaMonte, Michael J.
    Zhang, Yuzheng
    Di, Chongzhi
    Rillamas-Sun, Eileen
    Hunt, Julie
    Ikramuddin, Farha
    Li, Wenjun
    Marshall, Steve
    Rosenberg, Dori
    Stefanick, Marcia L.
    Wallace, Robert
    LaCroix, Andrea Z.
    Show allShow less
    UMass Chan Affiliations
    Prevention Research Center
    Department of Medicine, Division of Clinical Informatics
    Document Type
    Journal Article
    Publication Date
    2019-04-01
    Keywords
    blood pressure
    cohort study
    falls
    hypertension
    older adults
    Behavioral Medicine
    Cardiovascular Diseases
    Clinical Epidemiology
    Community Health and Preventive Medicine
    Epidemiology
    Geriatrics
    Preventive Medicine
    Women's Health
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    Link to Full Text
    https://doi.org/10.1111/jgs.15732
    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 beta-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).
    Source

    J Am Geriatr Soc. 2019 Apr;67(4):726-733. doi: 10.1111/jgs.15732. Epub 2019 Jan 7. Link to article on publisher's site

    DOI
    10.1111/jgs.15732
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/44531
    PubMed ID
    30614525
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1111/jgs.15732
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