Antihypertensive medications, particularly diuretics, can lead to increased fracture risk for older adults, so healthcare providers should weigh those risks when prescribing them, authors of a new study emphasized.
“The use of antihypertensive medications is common among older adults to manage hypertension and prevent cardiovascular events,” the international research team led by Muhammad D. Nadeem at the University Hospitals Birmingham, in England, said. “Emerging evidence indicates that these medications may impact bone health, thereby influencing the risk of fractures in the elderly population.”
The researchers conducted a cross-sectional study of 299 older adults, ages 65 and above, who were diagnosed with hypertension and using antihypertensive medications. The study participants had all been admitted to hospital wards or visited an emergency department during the study period from February 2023 to July 2024.
The investigators found that patients who used antihypertensive medications that are diuretic were at significantly higher risk of 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,” the authors found.
The study’s findings were published last week in the journal Cureus.
The authors further noted that serious injuries like hip fractures and head injuries can carry morbidity and mortality rates similar to cardiovascular events. While the researchers did not establish a direct cause-and-effect relationship, the findings did indicate an association between antihypertensive medications and an elevated risk of serious fall injuries and fractures, as evidenced by 29.4% of the study sample sustaining major fractures.
“This study highlights the need for careful consideration of fracture risk in elderly patients using antihypertensive medications, particularly diuretics,” the authors concluded. “Healthcare providers should balance the benefits of blood pressure control with the potential risk of fractures in this population.”
The study’s findings support other recent research on the use of antihypertensive medications and increased fracture risk in nursing home residents. A large study published in April of more than 29,000 older long-term care residents found that the initiation of antihypertensive medication was associated with elevated risks of fractures and falls, particularly among residents with dementia.
