Initiating a new prescription for blood pressure medications may serve to more than double the risk of life-threatening bone fractures, according to a recent study of more than 30,000 nursing home residents.
The study, which was published in JAMA Internal Medicine, asked whether the initiation of antihypertensive medications is associated with increased fracture risk among long-term Veterans Health Administration (VA) nursing home residents.
The retrospective cohort study used data derived from 29,648 older VA nursing home residents from 2006-2019.Average age was 78.0 and the group was 97.7% male. The control arm included 64,710 residents, average age 77.9 years. When looking fractures to the hip, pelvis, humerus, radius, or ulna, the researchers found the incidence rate of fractures per 100 person-years was 5.4 in the group initiating antihypertensives compared with 2.2 in the control group. These medications were also linked to higher risk of severe falls requiring hospitalizations or emergency department visits. Fracture risk affected subgroups differently, with dementia, systolic BP of ≥140mgHg, and diastolic BP of ≥80mmHg facing at least triple the fracture risk of the control group.
The findings, the authors concluded, indicated that initiation of blood pressure medications may be associated with elevated risks of both fractures and falls. They advise additional monitoring of such patients when initiating these drugs.
Source: Dave CV, Li Y, Steinman MA, et al. Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents. JAMA Intern Med. 2024;184(6):661–669. doi:10.1001/jamainternmed.2024.0507
