There is no shortage of issues to be concerned about when your elderly parent lives alone. Is your mom or dad eating well, taking care of hygiene needs, and remembering to take medication on time? Due to recent studies, adult kids are now likely to worry that the medication prescribed to lower hypertension may place their parents at risk for falls. As most are aware, falls can cause devastating injures in the elderly including bone fractures, dislocated joints and even brain injuries. These types of serious injuries frequently require hospitalizations, lengthy rehab center stays and changes in a senior's level of independence.
What is the risk for falls associated with use of Anti-Hypertension Drugs and how do you evaluate the risk vs benefits? What are the current medical findings?
Study results published in 2014 by the Yale School of Medicine (JAMA Internal Medicine, April 2014), indicated that the incidence of serious fall injuries among moderate users of anti-hypertensive medications was 40% higher than seniors who did not take these medications. This finding led to increased scrutiny and discussion in the medical community over the proper use blood pressure lowering meds in elderly patients. Physicians and patients have wrestled with the question of whether to avoid a heart attack by using drugs associated with an almost equal risk of serious fall? Who wants to make that choice?
Fortunately, updated study results are available to assist physicians in making important treatment decisions for their patients. Findings presented in 2015 at the American Society of Hypertension supported earlier research that anti-hypertensives are associated with increased fall risk but within certain time parameters. The analysis of more than 90,000 patients with a mean age of 81 years showed that initiating medication for treatment of high blood pressure increased the odds of having a serious fall injury within the next 15 days by 36%. There was no significant association between initial use of the medication and falls between 15 and 90 days later. In short, the 1 to 14 day window after adding a new medication is a risky time for falls. Another study published in Hypertension, found that there was no association between chronic use of anti hypertensives and increased risk of falls over the 1 year period studied in a 500 patient study.
What do these findings mean for my elderly parent(s)?
Essentially, if your parent has been taking medications to treat high blood pressure over a lengthy period of time; there is likely no increased risk of falls due to the medication. However, if your parent begins treatment for high blood pressure, changes medication or dosage; there is an increased risk for falls within the first several weeks. There does not seem to be a difference in risk based on the type or class of medication used or the number of medications used to treat the blood pressure. Consider the following when starting or changing your parent's medication protocol:
Talk to your physician about the risks and benefits of treating the hypertension with medication for your parent. Medical authorities have recently relaxed the goals for blood pressure among older patients. Recent guidelines suggest that patients over 60, without diabetes, kidney disease or other complicating factors should aim for 150/90. Always consult with your physician before making any changes to treatment protocols.
If your parent's physician recommends new treatment for hypertension or a change in medication or dosage, ask for information on possible side effects. This will allow you or another caregiver to be on alert for any potential medication related issues. Increased vigilance and supervision may be recommended for the first several weeks after medication changes.
Caregivers should create a log book to record the following information: time of day medication is administered, AM & PM blood pressure readings, any side effects such a dizziness or balance issues. Your parent's physician may request tracking of additional information---ask for guidance.
What's the bottom line? The benefits of anti hypertensive therapy are proven and well documented. However, additional vigilance is necessary when treating elderly patients to lessen the risk of falls during the early phase of treatment.
Do you need assistance elderly care for a loved one?
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