Blood pressure drugs tied to surprising fracture risk

As your age goes up, so can your risk for fractures.

And it’s a risk not to be taken lightly…

One-quarter of seniors who fracture a hip from a fall die within six months of the initial injury.

Other research shows 1-year mortality rates in hip fracture patients from nursing homes to be 36 percent for women and 54 percent for men.

And according to researchers at Rutgers University, there’s a surprising factor increasing this risk…

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The link between blood pressure medications and fracture

It wasn’t all that long ago that I warned about the threat long-term use of blood pressure drugs can pose to our kidneys. Now I need to share another…

As noted by Hanna Gaggin, MD, MPH and Daniel Kirshenbaum, MD from Harvard Health Publishing, “A common source of prescriptions is high blood pressure, with older adults often finding themselves on multiple medications to lower their blood pressure.”

Unfortunately, as the Rutgers research reveals, this could spell an increased fracture risk.

The researchers analyzed data from nearly 30,000 elderly patients in long-term care facilities from 2006 to 2019, comparing the 30-day risk of fractures for patients who began using blood pressure medications with similar patients who didn’t.

They found that the 30-day fracture risk for adults who began blood pressure medication was 5.4 per 100 people per year. Compare this to a rate of just 2.2 per 100 for patients who took no blood pressure medication.

Put simply, blood pressure medications more than double the risk of life-threatening bone fractures.

But why? They were associated with a side effect that contributed to falls.

A dangerous impact on balance

To ensure they could pinpoint falls caused by the use of the drugs, the team weeded out all other issues, like demographics and clinical history — and it came down to blood pressure drugs.

The research also revealed that certain people are at higher risk of fracture when taking these meds than others, including:

• High systolic blood pressure (when the first number of the blood pressure reading is above 139).
• High diastolic pressure (second number of the blood pressure reading above 79).
• And people with dementia.

The most extreme risk was found in people who had no recent use of blood pressure medication, who all experienced at least triple the chance of suffering a fracture within 30 days.

You’re probably wondering why taking these medications makes falls and fractures more likely.

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The researchers say that the increased risk is due to the medications’ negative effect on balance.

This is especially true when someone taking blood pressure drugs first stands up and temporarily experiences a drop in blood pressure that deprives the brain of oxygen. This is similar to what occurs with orthostatic hypertension.

And of course, interactions with other drugs (due to multiple prescriptions, known as poly-pharmacy) and existing balance problems that come with aging may only compound the problem.

Reducing fracture risk

While this study looked at nursing home residents, it’s important to remember that the median age of the people in this study was 77.

This means these fractures could just as easily happen to an older person at home. Therefore, it’s vital to know the steps to take to prevent falls and fractures if you or a loved one is taking medications for your blood pressure.

These include:

• Stand up slowly – Because blood pressure drops when you stand, an issue that is worse when you rise to quickly, be sure to take the time as you stand up to allow your pressure to adjust.
• Steady yourself – As you stand, hold onto something such as the back of a chair, a counter or the edge of a desk.
• Be aware – Caregivers and adult children should be aware of the potential fall dangers that come with blood pressure drugs in order to offer proactive support.

Falls present a real and present danger to both quality and length of life for older adults and many medications, not just blood pressure drugs, can play a significant role in their risk. Keep track of any medications you or your loved one are taking and take steps now to make falls and the fractures they cause less likely.

Sources:

Blood pressure drugs more than double bone-fracture risk in nursing home patients — EurekAlert

Is it safe to reduce blood pressure medications for older adults? — Harvard Health Publishing