Blood Pressure High? Be Aware Of This Little-Known Risk

There's been a rash of broken hips in the people of my orbit--enough that I think "Don't break your hip!" each time I step onto an unsteady surface.

So it caught my eye when I saw a new study on the association between blood pressure medications and risk of falls and fall-related injuries.

More than 75% of adults over age 65 and a surprising number of younger people have high blood pressure.

Dr. Peter Attia writes that blood pressure management – with lifestyle modifications and, when necessary, antihypertensive medications – is one of the most impactful moves you can make toward a longer, healthier life.

Unfortunately, medical interventions come with downsides and antihypertensive drugs are no exception.

Might these drugs increase your fall risk?

A study of nearly 30,000 Veteran's Administration patients, found that

• The fracture risk of the group taking antihypertensives was almost 2.5 times higher than controls.

• Patients starting antihypertensive medication had an 80% higher risk of falls requiring an emergency room visit or hospitalization.

• People had more fractures after starting an antihypertensive regimen.

Women have a higher incidence of hip fractures and 98% of the study subjects were male. We don't know if the added fracture risk would have been higher among women.

This study didn't look at specific hypertension drugs.

What's the antihypertensive-fall connection?

The most likely culprit is orthostatic hypotension. When you stand up quickly after lying or sitting, your blood pressure can suddenly drop, making you feel lightheaded or even causing you to faint. Antihypertensives can cause it to fall too low in these situations.

Orthostatic hypotension can also be caused by dehydration. When you're dehydrated, blood volume is reduced and blood flow to the brain can become inadequate, especially with changes in body position.

Don't stop taking your blood pressure medicine!

Controlling your blood pressure is critical to prevent cardiovascular events and death, kidney disease, and possibly dementia and other nervous system-related problems.

Be careful when first starting these drugs. The risk of falls and related injuries is particularly increased in the first month of taking antihypertensives. The risk was greatest for those starting their first blood pressure medication. Those who'd been on antihypertensives saw an increase in falls with the addition of a new drug.

Instead, take these measures....

🩺 When starting a new blood pressure therapy – whether it’s the first or fourth drug – be cautious and take measures to mitigate fall risk.

🩺 Stay well hydrated.

🩺 Attia says, "The greatest thing you can do to prevent falls – starting at any age – is to engage in resistance training to improve bone mineral density and build strength, especially in your feet and lower legs, as well as maintaining ankle mobility and balance."

.....because falls are serious business.

At least a quarter of adults age 65 and older fall each year, and falls are the leading cause of injury in this age group.

In 2021, about 100 elderly Americans died each day as the result of an unintentional fall.

Hip fractures can be particularly deadly for older adults, who are more than 2.5 times as likely to die within a year and 5-8 times more like to die in the first 3 months following the injury.

I leave you with these words of wisdom.....

"Don't break your hip!"