Initiating antihypertensive drugs in the elderly has been associated with an immediate increased risk of falls. The most likely mechanism is orthostatic hypotension, which is associated with dizziness and fainting. The effect is acute, occurs over a relatively short time, and may lead to falls, some of which can result in hip fractures.
The following study was undertaken to determine whether
initiation of antihypertensive drugs (e.g., thiazide diuretics, angiotensin II
converting–enzyme inhibitors, angiotensin II receptor blockers, calcium channel
blockers, or β-adrenergic blockers) was associated with an immediate increased
risk of hip fractures. Health care
administrative databases were used to identify patients initiating an
antihypertensive drug in Ontario, Canada. Elderly people who began receiving an antihypertensive
drug had a 43% increased risk of having a hip fracture during the first 45 days
following treatment initiation.