Antihypertensive Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study

被引:29
作者
Marcum, Zachary A. [1 ]
Perera, Subashan [1 ,2 ]
Newman, Anne B. [1 ,3 ]
Thorpe, Joshua M. [4 ,5 ]
Switzer, Galen E. [5 ,6 ,7 ]
Gray, Shelly L. [8 ]
Simonsick, Eleanor M. [9 ]
Shorr, Ronald I. [10 ]
Bauer, Douglas C. [11 ]
Castle, Nicholas G. [12 ]
Studenski, Stephanie A.
Hanlon, Joseph T. [1 ,2 ,3 ,4 ,13 ]
机构
[1] Univ Pittsburgh, Dept Geriatr Med, Pittsburgh, PA 15260 USA
[2] Univ Pittsburgh, Dept Biostat, Pittsburgh, PA 15260 USA
[3] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15260 USA
[4] Univ Pittsburgh, Dept Pharm & Therapeut, Pittsburgh, PA 15260 USA
[5] Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equity Res, Pittsburgh, PA USA
[6] Univ Pittsburgh, Dept Med Gen Internal, Pittsburgh, PA 15260 USA
[7] Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15260 USA
[8] Univ Washington, Sch Pharm, Seattle, WA 98195 USA
[9] NIA, Intramural Res Program, Baltimore, MD 21224 USA
[10] North Florida South Georgia Vet Hlth Syst GRECC, Gainesville, FL USA
[11] Univ Calif San Francisco, Div Gen Internal Med, San Francisco, CA 94143 USA
[12] Univ Pittsburgh, Dept Hlth Policy & Management, Pittsburgh, PA 15260 USA
[13] Vet Affairs Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA USA
来源
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES | 2015年 / 70卷 / 12期
基金
美国国家卫生研究院;
关键词
Falls; Medication; Epidemiology; Drug related; DRUG-USE; MEDICATIONS; RISK; PREDICTORS; FRACTURES; PEOPLE; AGE;
D O I
10.1093/gerona/glv095
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background. Despite wide-spread use of antihypertensives in older adults, the literature is unclear about their association with incident recurrent falls over time. Methods. Health, Aging and Body Composition study participants (n = 2,948) who were well functioning at baseline (1997) were followed to Year 7 (2004). The main outcome was recurrent falls (>= 2) in the ensuing 12 months. Antihypertensive use was examined as: (a) any versus none, (b) long-versus short-term (<= 2 vs <2 years), and by (c) summated standardized daily dose (SDD; 1 = maximum recommended daily dose for one antihypertensive), and (d) subclass. Results. Controlling for potential demographic, health status/behavior and access to care confounders, we found no increase in risk of recurrent falls in antihypertensive users compared to nonusers (adjusted odds ratio [AOR] = 1.13; 95% CI = 0.88-1.46), or those taking higher SDDs or for longer durations. Only those using a loop diuretic were found to have a modest increased risk of recurrent falls (AOR = 1.50; 95% CI = 1.11-2.03). Conclusions. Antihypertensive use overall was not statistically significantly associated with recurrent falls after adjusting for important confounders. Loop diuretic use may be associated with recurrent falls and needs further study.
引用
收藏
页码:1562 / 1568
页数:7
相关论文
共 34 条
[1]   FUROSEMIDE COMPARED WITH HYDROCHLOROTHIAZIDE - LONG-TERM TREATMENT OF HYPERTENSION [J].
ARAOYE, MA ;
CHANG, MY ;
KHATRI, IM ;
FREIS, ED .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1978, 240 (17) :1863-1866
[2]   ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly [J].
Aronow, Wilbert S. ;
Fleg, Jerome L. ;
Pepine, Carl J. ;
Artinian, Nancy T. ;
Bakris, George ;
Brown, Alan S. ;
Ferdinand, Keith C. ;
Forciea, Mary Ann ;
Frishman, William H. ;
Jaigobin, Cheryl ;
Kostis, John B. ;
Mancia, Giuseppi ;
Oparil, Suzanne ;
Ortiz, Eduardo ;
Reisin, Efrain ;
Rich, Michael W. ;
Schocken, Douglas D. ;
Weber, Michael A. ;
Wesley, Deborah J. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 57 (20) :2037-2114
[3]   New loop diuretic prescriptions may be an acute risk factor for falls in the nursing home [J].
Berry, Sarah D. ;
Mittleman, Murray A. ;
Zhang, Yuqing ;
Solomon, Daniel H. ;
Lipsitz, Lewis A. ;
Mostofsky, Elizabeth ;
Goldense, Dana ;
Kiel, Douglas P. .
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 2012, 21 (05) :560-563
[4]   The risk of falls on initiation of antihypertensive drugs in the elderly [J].
Butt, D. A. ;
Mamdani, M. ;
Austin, P. C. ;
Tu, K. ;
Gomes, T. ;
Glazier, R. H. .
OSTEOPOROSIS INTERNATIONAL, 2013, 24 (10) :2649-2657
[5]   Congruence of medication information from a brown bag data collection and pharmacy records: Findings from the Seattle Longitudinal Study [J].
Caskie, GIL ;
Willis, SL ;
Schaie, KW ;
Zanjani, FAK .
EXPERIMENTAL AGING RESEARCH, 2006, 32 (01) :79-103
[6]  
Chu LW, 2005, ANN ACAD MED SINGAP, V34, P60
[7]   Is a fall just a fall: Correlates of falling in healthy older persons. The health, aging and body composition study [J].
de Rekeneire, N ;
Visser, M ;
Peila, R ;
Nevitt, MC ;
Cauley, JA ;
Tylavsky, FA ;
Simonsick, EM ;
Harris, TB .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2003, 51 (06) :841-846
[8]   AN APPROACH TO THE ANALYSIS OF REPEATED MEASUREMENTS [J].
DIGGLE, PJ .
BIOMETRICS, 1988, 44 (04) :959-971
[9]  
Diggle PJ., 2002, ANAL LONGITUDINAL DA, V2nd ed., P2002
[10]   American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults [J].
Fick, Donna ;
Semla, Todd ;
Beizer, Judith ;
Dombrowski, Robert ;
Brandt, Nicole ;
DuBeau, Catherine E. ;
Flanagan, Nina ;
Hanlon, Joseph ;
Hollmann, Peter ;
Linnebur, Sunny ;
Nau, David ;
Rehm, Bob ;
Sandhu, Satinderpal ;
Steinman, Michael .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2012, 60 (04) :616-631