Findings from the study, published in the BMJ, showed that patients taking blood pressure lowering treatment for an average of three years had an 18% increased risk of acute kidney injury and a 28% increased risk of syncope (fainting), but there was no link between treatment and falls or fractures.
The meta-analysis included data from 58 randomised controlled trials involving 280,638 participants and aimed to understand whether those on medication to lower their blood pressure were more likely to report a fall or experience other specific side-effects.
High blood pressure is one of the leading risk factors for cardiovascular disease worldwide, and affects half of people aged over 65 in the UK. For those who are frail or have underlying health conditions, clinical guidelines suggest doctors take a personalised approach to prescribing drugs to lower blood pressure, taking into account the risk that their patient may experience side effects like a fall or kidney injury.
While many meta-analyses of existing research studies review the effectiveness of blood pressure-lowering drugs, few have analysed data on their potential harms or looked for specific side effects.
Lead researcher, Dr James Sheppard, from the University of Oxford’s Nuffield Department of Primary Care Health Sciences, said, “Our analysis dispels the widely held belief that blood pressure-lowering drugs are linked to an increase in the risk of experiencing a fall. However, we did show a link between these drugs and the risk of passing out or experiencing sudden kidney problems, which can have a really major impact on an individual’s quality of life. For relatively fit patients, the risk of these side effects is likely to be very small, but for older people living with lots of long term conditions, the potential harms of treatment should be taken into consideration.
"With clinical guidelines around the world increasingly recommending more intensive treatment for high blood pressure, these findings will help doctors to take a more personalised approach to managing the condition, taking into account both the potential benefit of treatment as well as the harms.”
The team included researchers from the Universities of Oxford, Keele, Cambridge, and Bristol, funded by the Wellcome Trust, Royal Society and the National Institute for Health Research School for Primary Care Research.
Association between antihypertensive treatment and adverse events: systematic review and meta-analysis
Ali Albasri, Miriam Hattle, Constantinos Koshiaris et al
BMJ 2021;372:n189 doi: https://doi.org/10.1136/bmj.n189