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

作者：Marcum Zachary A^*; Perera Subashan; Newman Anne B; Thorpe Joshua M; Switzer Galen E; Gray Shelly L; Simonsick Eleanor M; Shorr Ronald I; Bauer Douglas C; Castle Nicholas G; Studenski Stephanie A; Hanlon Joseph T

来源：Journals of Gerontology Series A-Biological Sciences and Medical Sciences, 2015, 70(12): 1562-1568.

DOI：10.1093/gerona/glv095

• Falls
• Medication
• Epidemiology
• Drug related

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.

• 出版日期2015-12