Aggressive blood pressure treatment does not increase fall risk after all, study says

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Taking aggressive measures to lower older adults' blood pressure may not increase their risk of falls, contrary to conventional wisdom, according to recently published research findings.

The idea that intensive treatment of hypertension could actually lead to low blood pressure that puts seniors at risk of falls is a “commonly cited concern,” the investigators stated. However, “few rigorous studies” have examined the issue.

The researchers compared the number of self-reported falls in two groups of participants with type 2 diabetes. One group was receiving intensive hypertension treatment, and the other was receiving a more standard treatment. The intensive group was more commonly prescribed “all classes of medications,” especially thiazide diuretics, the investigators noted. There were about 3,100 participants in total, and the mean age was 62.

The group in intensive treatment did not experience more falls or fall-related fractures than the other group over an average follow-up period of about five years, the study authors found. Results did not differ based on patient age.

The study participants were all enrolled in the Action to Control Cardiovascular Risk in Diabetes trial, testing a variety of treatments. This means they were observed more closely than patients in clinical practice, which could have affected the results of the hypertension study, the authors acknowledged.

Full findings appear in the Journal of General Internal Medicine.
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