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

被引:30
|
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
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.
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页码:1562 / 1568
页数:7
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