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Impact of Intensive Blood Pressure Therapy on Concern About Falling: Longitudinal Results From the Systolic Blood Pressure Intervention Trial (SPRINT)

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Impact of Intensive Blood Pressure Therapy on Concern About Falling: Longitudinal Results From the Systolic Blood Pressure Intervention Trial (SPRINT)

Dan R Berlowitz et al. J Am Geriatr Soc.

Abstract

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.

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References

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