Media Releases

Anti-hypertensive drugs linked to increased risk of hip fracture

November 20, 2012

TORONTO, ON — Elder­ly peo­ple tak­ing anti-hyper­ten­sive drugs are at a 43 per cent increased risk of hav­ing a hip frac­ture in the first 45 days of treat­ment, accord­ing to research con­duct­ed by fam­i­ly med­i­cine Assis­tant Pro­fes­sor Dr. Debra Butt. A mem­ber of the Depart­ment of Fam­i­ly and Com­mu­ni­ty Med­i­cine at the Uni­ver­si­ty of Toron­to and a fam­i­ly physi­cian affil­i­at­ed with The Scar­bor­ough Hos­pi­tal, Dr. Butt’s study was pub­lished on Novem­ber 19, 2012 in Archives of Inter­nal Med­i­cine. The study exam­ined data from health care admin­is­tra­tive data­bas­es in Ontario, look­ing at records from 2000 to 2009 for com­mu­ni­ty-dwelling hyper­ten­sive patients with a mean age of 80.8 years.

There are seri­ous con­se­quences to a hip frac­ture for the elder­ly. In the first year of a hip frac­ture there is a high­er mor­tal­i­ty rate than is seen for many chron­ic dis­eases. Those who recov­er often lose their inde­pen­dence due to reduced mobil­i­ty, which can result in depres­sion and over­all decreased qual­i­ty of life.

By act­ing on find­ings of this study, elder­ly Cana­di­an patients and their physi­cians can take steps to man­age the increased risk of hip frac­tures from new­ly-pre­scribed anti-hyper­ten­sive drugs. Patients are pre­scribed these drugs to treat hyper­ten­sion (high blood pres­sure), and the drugs are shown to help pre­vent strokes and heart attacks. One side effect is a sud­den drop in blood pres­sure, such as those that occur dur­ing sud­den upright move­ment or change of posi­tion, which can cause dizzi­ness or weak­ness. In the elder­ly, a sud­den drop in blood pres­sure can con­tribute to falls, which is the main under­ly­ing cause of 90 per cent of hip frac­tures.

“It’s impor­tant for patients to be edu­cat­ed on the poten­tial risk of a hip frac­ture when they start an anti-hyper­ten­sive drug. They should be cau­tious; if they expe­ri­ence dizzi­ness or weak­ness, they need to let their doc­tor know, and should not engage in activ­i­ties that would put them at risk of falling. For exam­ple, if you start your anti-hyper­ten­sive drug before bed and get up in the mid­dle of the night to go to the bath­room, be care­ful, you could be dizzy,” says Dr. Butt.

Pri­or to this study there was no real evi­dence that tak­ing an anti-hyper­ten­sive drug could cause increased seri­ous fall-relat­ed injuries among the elder­ly through their effect on blood pres­sure. The study adds the anti-hyper­ten­sive class of drugs to the list of oth­er psy­chotrop­ic drugs that have sim­i­lar side effects on drug ini­ti­a­tion, such as anti-depres­sants and sleep­ing pills. Dr. Butt cau­tions that these find­ings are not a rea­son to stop tak­ing anti-hyper­ten­sive drugs.

“We are not say­ing don’t take these drugs; they are proven to reduce risk the risk of stroke and heart attacks. Just be cau­tious when start­ing them,” says Dr. Butt.


For fur­ther infor­ma­tion con­tact:

Danielle Win­trip
Com­mu­ni­ca­tions Coor­di­na­tor
Depart­ment of Fam­i­ly and Com­mu­ni­ty Med­i­cine
Temer­ty Temer­ty Fac­ul­ty of Med­i­cine, Uni­ver­si­ty of Toron­to
Office: 416–978-8793