Takeaway
- The use of angiotensin-converting enzyme inhibitors (ACEi), β-blockers (BB) and calcium channel blockers (CCB) may be associated with decreased risk for injurious falls among older adults.
Why this matters
- The risk for fall and fall-related injuries are common and are potentially severe in older adults > 60 years of age.
- Medications such as hypnotics and anti-Parkinson’s medications are known to be a major risk factor for fall, but the role of other medications is unclear, particularly antihypertensives are a concern as many older adults consume them long-term.
Study design
- Systematic review and meta‑analyses of 78 articles involving adults patients aged ≥60 years receiving antihypertensive medications from inception through 10 July 2017.
- Antihypertensives used were α-blockers (AB), ACEi, angiotensin receptor blockers (ARB), BB, CCB, and diuretics.
- Funding: None disclosed.
Key results
- Overall, 46 studies assessed for falls, 30 studied injurious falls, and 14 studied recurrent falls.
- Lower risk for injurious falls was seen in patients using ACEi (OR, 0.85; 95% CI, 0.81-0.89), BB (OR, 0.84; 95% CI, 0.76-0.93) and CCB (OR, 0.81; 95% CI, 0.74–0.90) vs nonusers.
- No association was seen between the use of AB, ARB and diuretics and the risk for falls.
Limitations
- Risk for bias.
- Changes in antihypertensive medication were not assessed.
References
References