Nadeem Muhammad D, Ali Junaid, Shah Shahin, Mahmood Abroo, Ahmad Umair
Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR.
General Medicine, Khyber Medical University, Peshawar, PAK.
Cureus. 2024 Sep 19;16(9):e69714. doi: 10.7759/cureus.69714. eCollection 2024 Sep.
Background The use of antihypertensive medications is common among older adults to manage hypertension and prevent cardiovascular events. However, the potential impact of these medications on bone health and the risk of fractures remains a concern. This study investigates the association between antihypertensive medication use and fracture risk in elderly individuals. Materials and methods A cross-sectional study was conducted from February 2023 to July 2024, including 299 elderly patients (aged ≥65) diagnosed with hypertension and currently using antihypertensive medications. Data were collected from medical records, focusing on demographics, fracture incidence, comorbid conditions, and medication use. Logistic regression models were used to analyze the association between antihypertensive use and fracture risk, adjusting for confounders. Results Among the participants, 110 reported falls, and 88 (29.43%) sustained fractures. Fractures were more prevalent among females (63.6%) and those aged 75-84 years (45.5%). A history of falls, mobility difficulties, osteoporosis, and urinary incontinence were significantly associated with fractures. While most antihypertensive classes did not show a significant association with fracture risk, diuretics were associated with a 2.3-fold increased risk of fractures (OR 2.30, p=0.037). Conclusions This study highlights the need for careful consideration of fracture risk in elderly patients using antihypertensive medications, particularly diuretics. Healthcare providers should balance the benefits of blood pressure control with the potential risk of fractures in this population.
背景 老年人中使用抗高血压药物来控制高血压和预防心血管事件很常见。然而,这些药物对骨骼健康的潜在影响以及骨折风险仍然是一个令人担忧的问题。本研究调查老年人使用抗高血压药物与骨折风险之间的关联。
材料和方法 于2023年2月至2024年7月进行了一项横断面研究,纳入了299名诊断为高血压且正在使用抗高血压药物的老年患者(年龄≥65岁)。从医疗记录中收集数据,重点关注人口统计学、骨折发生率、合并症和药物使用情况。使用逻辑回归模型分析抗高血压药物使用与骨折风险之间的关联,并对混杂因素进行调整。
结果 在参与者中,110人报告有跌倒,88人(29.43%)发生骨折。骨折在女性(63.6%)和75 - 84岁年龄组(45.5%)中更为普遍。跌倒史、行动困难、骨质疏松症和尿失禁与骨折显著相关。虽然大多数抗高血压药物类别与骨折风险没有显著关联,但利尿剂与骨折风险增加2.3倍相关(OR 2.30,p = 0.037)。
结论 本研究强调在使用抗高血压药物的老年患者中,尤其是使用利尿剂的患者,需要仔细考虑骨折风险。医疗保健提供者应在该人群中权衡血压控制的益处与骨折的潜在风险。