South Middlesex Times

A study conducted by Rutgers Health reveals that blood pressure medications significantly increase the risk of life-threatening bone fractures in nursing home residents. The research, which utilized records from nearly 30,000 patients, found that these medications more than double the fracture risk.

The study's authors attribute this increased risk to the medication's propensity to impair balance, especially when patients first stand up and temporarily experience low blood pressure. This deprives the brain of oxygen and is further complicated by interactions with other drugs and low baseline balance in many nursing home patients.

"Bone fractures often start nursing home patients on a downward spiral," said Chintan Dave, academic director of the Rutgers Center for Health Outcomes, Policy and Economics and lead author of the study. "Roughly 40 percent of those who fracture a hip die within the next year, so it’s truly alarming to find that a class of medications used by 70 percent of all nursing home residents more than doubles the bone-fracture risk."

Dave also noted that while many patients have high enough blood pressure that treatment benefits outweigh potential dangers, such patients require careful observation. "Caregivers think of blood pressure medication as very low risk, and that’s not true in this patient population,” he said.

The research team analyzed Veterans Health Administration data from 29,648 elderly patients in long-term care facilities from 2006 to 2019. They compared the 30-day risk of fractures to various body parts for patients who began using blood pressure medications with similar patients who didn’t.

The findings revealed an elevated fracture risk in certain subgroups. Patients with dementia or high systolic or diastolic blood pressure readings or no recent use of blood pressure medication experienced at least triple the fracture risk of unmedicated patients.

With approximately 2.5 million Americans living in nursing homes or assisted living facilities and up to half experiencing falls each year, these findings indicate that a combination of less medication and better support could significantly reduce the problem.

"Caregivers can’t strike this right balance of risk and reward if they don’t have accurate data about the risks,” Dave said. “I hope this study gives them information that helps them serve their patients better."