Dataset Information

Anti-hypertensive medications and injurious falls in an older population of low socioeconomic status: a nested case-control study.

ABSTRACT:

Background

This study aimed to determine whether the number of anti-hypertensive medication classes or any change in anti-hypertensive medication were associated with injurious fall among the community-dwelling older population of low socioeconomic status.

Methods

Using data from electronic medical records, we performed a nested case-control study among older Singapore residents (?60) of low socioeconomic status (N?=?210). Controls (n?=?162) were matched to each case (n?=?48) by age and gender. Variables with p?ResultsThe mean (±SD) age of participants was 78.1 (± 8.33) years; 127 (60.4%) were female, 189 (90.0%) were Chinese. Those on ?2 anti-hypertensive medication classes had an increased risk of experiencing an injurious fall compared to those not on any anti-hypertensive medication (OR?=?5.45; CI:1.49-19.93; p?=?0.01). Among those who were taking anti-hypertensive medication, those who had a change in the medication 180-day prior to injurious fall had a significantly increased risk of experiencing an injurious fall compared to those that did not report any change in anti-hypertensive medication (OR?=?3.88; CI:1.23-12.19; p?=?0.02). Sensitivity analyses generated consistent findings.

Conclusion

Both ?2 anti-hypertensive medication classes and change in anti-hypertensive medication were associated with an increased risk of experiencing an injurious fall among the older population of low socioeconomic status. Our findings could guide prescribers to exercise caution in the initiation of anti-hypertensive medications or in making medication changes, especially among the older population of low socioeconomic status.

SUBMITTER: Banu Z

PROVIDER: S-EPMC6114512 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

Anti-hypertensive medications and injurious falls in an older population of low socioeconomic status: a nested case-control study.

Banu Zafirah Z Lim Ka Keat KK Kwan Yu Heng YH Yap Kai Zhen KZ Ang Hui Ting HT Tan Chuen Seng CS Fong Warren W Thumboo Julian J Lee Kheng Hock KH Ostbye Truls T Low Lian Leng LL

BMC geriatrics 20180828 1

<h4>Background</h4>This study aimed to determine whether the number of anti-hypertensive medication classes or any change in anti-hypertensive medication were associated with injurious fall among the community-dwelling older population of low socioeconomic status.<h4>Methods</h4>Using data from electronic medical records, we performed a nested case-control study among older Singapore residents (≥60) of low socioeconomic status (N = 210). Controls (n = 162) were matched to each case (n = 48) by a ...[more]

PMID: 30153807

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Project description:Randomized trials of anti-hypertensive treatment demonstrating reduced risk of cardiovascular events in older adults included participants with less comorbidity than clinical populations. Whether these results generalize to all older adults, most of whom have multiple chronic conditions, is uncertain.To determine the association between anti-hypertensive medications and CV events and mortality in a nationally representative population of older adults.Competing risk analysis with propensity score adjustment and matching in the Medicare Current Beneficiary Survey cohort over three-year follow-up through 2010.4,961 community-living participants with hypertension.Anti-hypertensive medication intensity, based on standardized daily dose for each anti-hypertensive medication class participants used.Cardiovascular events (myocardial infarction, unstable angina, cardiac revascularization, stroke, and hospitalizations for heart failure) and mortality.Of 4,961 participants, 14.1% received no anti-hypertensives; 54.6% received moderate, and 31.3% received high, anti-hypertensive intensity. During follow-up, 1,247 participants (25.1%) experienced cardiovascular events; 837 participants (16.9%) died. Of deaths, 430 (51.4%) occurred in participants who experienced cardiovascular events during follow-up. In the propensity score adjusted cohort, after adjusting for propensity score and other covariates, neither moderate (adjusted hazard ratio, 1.08 [95% CI, 0.89-1.32]) nor high (1.16 [0.94-1.43]) anti-hypertensive intensity was associated with experiencing cardiovascular events. The hazard ratio for death among all participants was 0.79 [0.65-0.97] in the moderate, and 0.72 [0.58-0.91] in the high intensity groups compared with those receiving no anti-hypertensives. Among participants who experienced cardiovascular events, the hazard ratio for death was 0.65 [0.48-0.87] and 0.58 [0.42-0.80] in the moderate and high intensity groups, respectively. Results were similar in the propensity score-matched subcohort.In this nationally representative cohort of older adults, anti-hypertensive treatment was associated with reduced mortality but not cardiovascular events. Whether RCT results generalize to older adults with multiple chronic conditions remains uncertain.

Dataset Information

Anti-hypertensive medications and injurious falls in an older population of low socioeconomic status: a nested case-control study.

Background

Methods

Conclusion

Publications

Anti-hypertensive medications and injurious falls in an older population of low socioeconomic status: a nested case-control study.

Similar Datasets

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