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dc.contributor.authorMargolis, Karen L.
dc.contributor.authorBuchner, David M.
dc.contributor.authorLaMonte, Michael J.
dc.contributor.authorZhang, Yuzheng
dc.contributor.authorDi, Chongzhi
dc.contributor.authorRillamas-Sun, Eileen
dc.contributor.authorHunt, Julie
dc.contributor.authorIkramuddin, Farha
dc.contributor.authorLi, Wenjun
dc.contributor.authorMarshall, Steve
dc.contributor.authorRosenberg, Dori
dc.contributor.authorStefanick, Marcia L.
dc.contributor.authorWallace, Robert
dc.contributor.authorLaCroix, Andrea Z.
dc.date2022-08-11T08:10:19.000
dc.date.accessioned2022-08-23T17:03:55Z
dc.date.available2022-08-23T17:03:55Z
dc.date.issued2019-04-01
dc.date.submitted2019-05-02
dc.identifier.citation<p>J Am Geriatr Soc. 2019 Apr;67(4):726-733. doi: 10.1111/jgs.15732. Epub 2019 Jan 7. <a href="https://doi.org/10.1111/jgs.15732">Link to article on publisher's site</a></p>
dc.identifier.issn0002-8614 (Linking)
dc.identifier.doi10.1111/jgs.15732
dc.identifier.pmid30614525
dc.identifier.urihttp://hdl.handle.net/20.500.14038/44531
dc.description.abstractBACKGROUND/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).
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30614525&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1111/jgs.15732
dc.subjectblood pressure
dc.subjectcohort study
dc.subjectfalls
dc.subjecthypertension
dc.subjectolder adults
dc.subjectBehavioral Medicine
dc.subjectCardiovascular Diseases
dc.subjectClinical Epidemiology
dc.subjectCommunity Health and Preventive Medicine
dc.subjectEpidemiology
dc.subjectGeriatrics
dc.subjectPreventive Medicine
dc.subjectWomen's Health
dc.titleHypertension Treatment and Control and Risk of Falls in Older Women
dc.typeJournal Article
dc.source.journaltitleJournal of the American Geriatrics Society
dc.source.volume67
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/prc_pubs/120
dc.identifier.contextkey14417348
html.description.abstract<p>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.</p> <p>DESIGN/SETTING: Prospective cohort study.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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).</p>
dc.identifier.submissionpathprc_pubs/120
dc.contributor.departmentPrevention Research Center
dc.contributor.departmentDepartment of Medicine, Division of Clinical Informatics
dc.source.pages726-733


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