16 May Rutgers Study Finds Marked Increase in Fractures in Nursing Home Patients Started on Blood Pressure Meds

MedicalResearch.com Interview with:

Dr. Chintan Dave

Chintan V. Dave PharmD, PhD
Assistant Professor of Pharmacy and Epidemiology
Assistant Director
Rutgers Center for Pharmacoepidemiology and Treatment Science
Academic Director
Rutgers Center for Health Outcomes, Policy, and Economics
Rutgers University
New Brunswick, New Jersey

MedicalResearch.com: What is the background for this study?

Response: Our study examined the association between initiation of an antihypertensive medication and its correlation with fracture risk among older nursing home veterans.

MedicalResearch.com: What are the main findings?

Response:  We found that starting an antihypertensive treatment was associated with a significant increase in fracture risk. More specifically, the incidence rate of fractures per 100 person-years was 5.4 in residents who began antihypertensive therapy, compared to 2.2 in those who did not, which corresponded to an adjusted hazard ratio of 2.42 (95% CI, 1.43-4.08)

The most critical finding from our study for healthcare professionals, is the notable increase in fracture risk following the initiation of antihypertensive medications in older nursing home residents.

This risk was even more pronounced among specific groups, such as those with dementia, higher baseline blood pressures, and residents who were not recently on any antihypertensive.

MedicalResearch.com: What can be done to minimize the risk from antihypertensives?

Response:  Given the increased risk of fractures associated with initiating antihypertensive medications, we recommend healthcare professionals adopt a cautious approach. It is crucial to:

• • • Assess Individual Risk: Before initiating treatment, evaluate each patient’s risk factors for falls and fractures, including their cognitive status and previous fall history.
    • Monitor Closely: After starting antihypertensive therapy, closely monitor patients for signs of adverse effects such as dizziness or unsteadiness, which can predispose them to falls.
    • Adjust Treatment as Necessary: Be prepared to adjust dosages or switch medications if patients experience adverse effects 

Citation: Dave CV, Li Y, Steinman MA, et al. Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents. JAMA Intern Med. Published online April 22, 2024. doi:10.1001/jamainternmed.2024.0507

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2818019

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Last Updated on May 16, 2024 by Marie Benz MD FAAD