Objectives: Concern about falling is common among older hypertension patients and could impact decisions to intensify blood pressure therapy. Our aim was to determine whether intensive therapy targeting a systolic blood pressure (SBP) of 120 mm Hg is associated with greater changes in concern about falling when compared with standard therapy targeting an SBP of 140 mm Hg.
Design: Subsample analysis of participants randomized to either intensive or standard therapy in the Systolic Blood Pressure Intervention Trial (SPRINT).
Setting: Approximately 100 outpatient sites.
Participants: A total of 2313 enrollees in SPRINT; participants were all age 50 or older (mean = 69 y) and diagnosed with hypertension.
Measurements: Concern about falling was described by the shortened version of the Falls Efficacy Scale International as measured at baseline, 6 months, 1 year, and annually thereafter.
Results: Concern about falling showed a small but significant increase over time among all hypertension patients. No differences were noted, however, among those randomized to intensive vs standard therapy (P = .95). Among participants younger than 75 years, no increase in concern about falling over time was noted, but among participants aged 75 years and older, the mean falls self-efficacy score increased by .3 points per year (P < .0001). No differences were observed between the intensive and standard treatment groups when stratified by age (P = .55).
Conclusion: Intensive blood pressure therapy is not associated with increased concern about falling among older hypertension patients healthy enough to participate in SPRINT.
Keywords: concern about falling; falls; hypertension.
© 2019 The American Geriatrics Society.
Hypertension Treatment and Concern About Falling: Baseline Data From the Systolic Blood Pressure Intervention TrialDR Berlowitz et al. J Am Geriatr Soc 64 (11), 2302-2306. PMID 27640987. - Randomized Controlled TrialAlthough 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 b …
Effect of Intensive vs Standard Blood Pressure Treatment Upon Erectile Function in Hypertensive Men: Findings From the Systolic Blood Pressure Intervention TrialCG Foy et al. J Sex Med. PMID 31862174.In a sample of male patients at high risk for cardiovascular events but without diabetes, targeting a SBP of less than 120 mm Hg, as compared with less than 140 mm Hg, re …
Systolic Blood Pressure Intervention Trial (SPRINT) and Target Systolic Blood Pressure in Future Hypertension GuidelinesBM Egan et al. Hypertension 68 (2), 318-23. PMID 27354422.The Systolic Blood Pressure (SBP, mm Hg) Intervention Trial (SPRINT) showed that targeting SBP <120 mm Hg (intensive treatment, mean SBP: 121.5 mm Hg) versus <140 ( …
Impact of the SPRINT Trial on Hypertension ManagementL Ghazi et al. Annu Rev Med 69, 81-95. PMID 29414255. - ReviewThe Systolic Blood Pressure Intervention Trial is the first large prospective randomized controlled trial to demonstrate the benefit of an intensive systolic blood pressu …
Interventions for Preventing Falls in Older People Living in the CommunityLD Gillespie et al. Cochrane Database Syst Rev (9), CD007146. PMID 22972103. - ReviewGroup and home-based exercise programmes, and home safety interventions reduce rate of falls and risk of falling.Multifactorial assessment and intervention programmes red …
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