A new study has found that starting blood pressure medicine could increase the risk of falls, broken bones, and fainting in older adults living in nursing homes.
The research was published in the journal JAMA Internal Medicine and led by Dr. Chintan V. Dave from Rutgers University. The team studied a large group of older veterans who live in long-term care facilities.
The researchers used health records from almost 30,000 veterans in the Veterans Health Administration system. To better understand the risks, they used a method called “target trial emulation.”
This technique tries to recreate the conditions of a clinical trial using real patient data. It helps researchers study what happens in real life, especially when it’s not possible to run a large, controlled trial.
What they found was concerning. Among nursing home residents who started taking blood pressure medications, the rate of bone fractures was 5.4 per 100 person-years. That means for every 100 people, more than five had a fracture in a year.
In comparison, people who didn’t start the medication had a much lower rate—just 2.2 per 100 person-years. This shows that those taking the medicine had more than twice the risk of breaking a bone.
The study also found other risks. People who started blood pressure treatment were almost twice as likely to have a serious fall—one that required a visit to the emergency room or a stay in the hospital. They were also more likely to faint, with the risk of fainting going up by about 70%.
Some groups were especially at risk. These included people with dementia, those who had high blood pressure readings (above 140/80 mmHg), and those who had not taken blood pressure medicine recently. For these residents, the risk of fractures was up to nearly five times higher than for others.
These results are important because many older adults in nursing homes are already weak or have other health issues. Adding a new blood pressure medicine may make them more likely to fall or faint, especially in the first few weeks.
While it’s still important to control high blood pressure to prevent heart attacks and strokes, doctors need to be very careful when starting treatment in older people.
The researchers suggest that doctors should take a personalized approach. Instead of using the same treatment for everyone, they should consider each person’s overall health, how likely they are to fall, and whether they have conditions like dementia.
Starting with low doses, changing them slowly, and using non-drug methods—like changes in diet or exercise—may be safer for some people.
This study is a strong reminder that medicine can have side effects, especially in older adults. It supports the idea that when it comes to treating high blood pressure in the elderly, it’s best to “start low and go slow.” That way, doctors can help protect their patients’ hearts without putting them at risk of serious injuries.
For those interested in other ways to manage blood pressure, including healthy diets or nutrients like potassium, there are many studies and trusted health resources available. Keeping blood pressure in a safe range is important—but doing it in a safe and gentle way matters just as much.
If you care about blood pressure, please read studies about Intensive blood pressure treatment for older adults may harm heart and kidneys and What you should know about high blood pressure medications.
For more about blood pressure, please read studies about High blood pressure and marijuana: a risky combination and Common blood pressure drug may not prevent heart attack effectively.
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