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

J Am Geriatr Soc. 2020 Mar;68(3):614-618. doi: 10.1111/jgs.16264. Epub 2019 Nov 28.

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. J Am Geriatr Soc 68:614-618, 2020.

Trial registration: ClinicalTrials.gov NCT01206062.

Keywords: concern about falling; falls; hypertension.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Longitudinal Studies
  • Male

Substances

  • Antihypertensive Agents

Associated data

  • ClinicalTrials.gov/NCT01206062