Falls among elderly hypertensives--are they iatrogenic?

A cohort of 1,002 elderly ambulatory hypertensive patients were studied for nearly 4 years by this historical prospective design to determine the morbidity and mortality of the cohort and whether the level of blood pressure and antihypertensive medications increase the risk of falling in this group. During this time 148 reported falls; there were no resultant deaths in this cohort. Relative risk analysis derived from the logistic regression model demonstrated that neither blood pressure level nor type of antihypertensive medication was associated with falling after adjustment for confounding variables. Women, those who resided in nursing homes, although still considered to be ambulatory, and those with complaints of weakness, dizziness and/or orthostatic hypotensive symptoms were at higher risk of falling. These latter do not appear to be related to hypertension treatment. To discontinue this treatment, without further investigation of the symptoms, will not reduce the risk of falling but will increase the risk of a morbid or fatal event.