Berlowitz Dan R, Breaux-Shropshire Tonya, Foy Capri G, Gren Lisa H, Kazis Lewis, Lerner Alan J, Newman Jill C, Powell James R, Riley William T, Rosman Robert, Wadley Virginia G, Williams Julie A
Bedford Veterans Affairs Hospital, Bedford, Massachusetts.
Department of Health Law, Policy and Management, School of Public Health, Boston University, Boston, Massachusetts.
J Am Geriatr Soc. 2016 Nov;64(11):2302-2306. doi: 10.1111/jgs.14441. Epub 2016 Sep 19.
To determine the extent of concern about falling in older adults with hypertension, whether lower blood pressure (BP) and greater use of antihypertensive medications are associated with greater concern about falling, and whether lower BP has a greater effect on concern about falling in older and more functionally impaired individuals.
Secondary analysis involving cross-sectional study of baseline characteristics of participants enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT).
Approximately 100 outpatient sites.
SPRINT enrollees aged 50 and older (mean age 69) diagnosed with hypertension (N = 2,299).
Concern about falling was determined using the shortened version of the Falls Efficacy Scale International as measured at the baseline examination.
Mild concern about falling was present in 29.3% of participants and moderate to severe concern in 17.9%. Neither low BP (systolic BP<120 mmHg, diastolic BP <70 mmHg) nor orthostatic hypotension was associated with concern about falling (P > .10). Participants with moderate to severe concern about falling were taking significantly more antihypertensive medications than those with mild or no concern. After adjusting for baseline characteristics, no associations were evident between BP, medications, and concern about falling. Results were similar in older and younger participants; interactions between BP and age and functional status were not significantly associated with concern about falling.
Although concern about falling is common in older adults with hypertension, it was not found to be associated with low BP or use of more antihypertensive medications in baseline data from SPRINT.
确定老年高血压患者对跌倒的担忧程度，较低的血压（BP）和更多地使用抗高血压药物是否与对跌倒的更大担忧相关，以及较低的血压对老年和功能障碍更严重的个体的跌倒担忧是否有更大影响。
对收缩压干预试验（SPRINT）参与者的基线特征进行横断面研究的二次分析。
约100个门诊地点。
SPRINT研究中年龄在50岁及以上（平均年龄69岁）且被诊断为高血压的参与者（N = 2299）。
在基线检查时使用国际跌倒效能量表的简化版来确定对跌倒的担忧程度。
29.3%的参与者存在对跌倒的轻度担忧，17.9%存在中度至重度担忧。低血压（收缩压<120 mmHg，舒张压<70 mmHg）和直立性低血压均与对跌倒的担忧无关（P>0.10）。对跌倒有中度至重度担忧的参与者服用的抗高血压药物明显多于轻度担忧或无担忧的参与者。在调整基线特征后，血压、药物与对跌倒的担忧之间无明显关联。老年和年轻参与者的结果相似；血压与年龄和功能状态之间的相互作用与对跌倒的担忧无显著关联。
尽管老年高血压患者对跌倒的担忧很常见，但在SPRINT的基线数据中未发现其与低血压或更多使用抗高血压药物有关。
