Evidence map›Paper›PMID 27166208›Full record

ArticleCirculation. Cardiovascular quality and outcomes2016

Short-Term Risk of Serious Fall Injuries in Older Adults Initiating and Intensifying Treatment With Antihypertensive Medication.

Daichi Shimbo, C Barrett Bowling, Emily B Levitan, Luqin Deng, John J Sim, Lei Huang, Kristi Reynolds, Paul Muntner

Open access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 4 pooled it
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 4 syntheses or guidelines pooled it, 87 citations in OpenAlex.

  1. Cardiovascular Disorders and Falls Among Older Adults: A Systematic Review and Meta-Analysis.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024
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  18. Complex Patterns of Antihypertensive Treatment Changes in Long-Term Care Residents.Journal of the American Medical Directors Association · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Daichi ShimboFrom the Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, GA (C.B.B.); Emory University, Atlanta, GA (C.B.B.); Department of Epidemiology (E.B.L.), Department of Epidemiology (L.D.), Department of Epidemiology (L.H.), and Department of Epidemiology (P.M.), University of Alabama at Birmingham; Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA (J.J.S.); and Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (K.R.). ds2231@cumc.columbia.edu.
C Barrett BowlingFrom the Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, GA (C.B.B.); Emory University, Atlanta, GA (C.B.B.); Department of Epidemiology (E.B.L.), Department of Epidemiology (L.D.), Department of Epidemiology (L.H.), and Department of Epidemiology (P.M.), University of Alabama at Birmingham; Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA (J.J.S.); and Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (K.R.).
Emily B LevitanFrom the Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, GA (C.B.B.); Emory University, Atlanta, GA (C.B.B.); Department of Epidemiology (E.B.L.), Department of Epidemiology (L.D.), Department of Epidemiology (L.H.), and Department of Epidemiology (P.M.), University of Alabama at Birmingham; Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA (J.J.S.); and Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (K.R.).
Luqin DengFrom the Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, GA (C.B.B.); Emory University, Atlanta, GA (C.B.B.); Department of Epidemiology (E.B.L.), Department of Epidemiology (L.D.), Department of Epidemiology (L.H.), and Department of Epidemiology (P.M.), University of Alabama at Birmingham; Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA (J.J.S.); and Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (K.R.).
John J SimFrom the Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, GA (C.B.B.); Emory University, Atlanta, GA (C.B.B.); Department of Epidemiology (E.B.L.), Department of Epidemiology (L.D.), Department of Epidemiology (L.H.), and Department of Epidemiology (P.M.), University of Alabama at Birmingham; Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA (J.J.S.); and Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (K.R.).
Lei HuangFrom the Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, GA (C.B.B.); Emory University, Atlanta, GA (C.B.B.); Department of Epidemiology (E.B.L.), Department of Epidemiology (L.D.), Department of Epidemiology (L.H.), and Department of Epidemiology (P.M.), University of Alabama at Birmingham; Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA (J.J.S.); and Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (K.R.).
Kristi ReynoldsFrom the Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, GA (C.B.B.); Emory University, Atlanta, GA (C.B.B.); Department of Epidemiology (E.B.L.), Department of Epidemiology (L.D.), Department of Epidemiology (L.H.), and Department of Epidemiology (P.M.), University of Alabama at Birmingham; Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA (J.J.S.); and Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (K.R.).
Paul MuntnerFrom the Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, GA (C.B.B.); Emory University, Atlanta, GA (C.B.B.); Department of Epidemiology (E.B.L.), Department of Epidemiology (L.D.), Department of Epidemiology (L.H.), and Department of Epidemiology (P.M.), University of Alabama at Birmingham; Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA (J.J.S.); and Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (K.R.).
Columbia University Irving Medical Center · USKaiser Permanente · USEmory University · USLos Angeles Medical Center · US

Funding

University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI BARBARA A GOWER · 2013 to 2026
$19.5M
Midcareer Investigator Award in Patient-Oriented Research in Human HypertensionK24HL125704 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHIMBO, DAICHI · 2015 to 2019
$573k
Trajectories of Kidney Dysfunction in Older Adults with Chronic Kidney DiseaseIK2CX000856 · VA · VETERANS HEALTH ADMINISTRATION · PI BOWLING, CHRISTOPHER BARRETT · 2013 to 2017
–
CSRD VA IK2 CX000856NHLBI NIH HHS K24 HL125704NIDDK NIH HHS P30 DK079626
6 · The paper itself

Abstract

backgroundAntihypertensive medication use has been associated with an increased risk of falls in some but not all studies. Few data are available on the short-term risk of falls after antihypertensive medication initiation and intensification. METHODS AND

resultsWe examined the association between initiating and intensifying antihypertensive medication and serious fall injuries in a case-crossover study of 90 127 Medicare beneficiaries who were ≥65 years old and had a serious fall injury between July 1, 2007, and December 31, 2012, based on emergency department and inpatient claims. Antihypertensive medication initiation was defined by a prescription fill with no fills in the previous year. Intensification was defined by the addition of a new antihypertensive class, and separately, titration by the addition of a new class or increase in dosage of a current class. Exposures were ascertained for the 15 days before the fall (case period) and six 15-day earlier periods (control periods). Overall, 272, 1508, and 3113 Medicare beneficiaries initiated, added a new class of antihypertensive medication or titrated therapy within 15 days of their serious fall injury. The odds for a serious fall injury was increased during the 15 days after antihypertensive medication initiation (odds ratio, 1.36 [95% confidence interval, 1.19-1.55]), adding a new class (odds ratio, 1.16 [95% confidence interval, 1.10-1.23]), and titration [odds ratio, 1.13 [95% confidence interval, 1.08-1.18]). These associations were attenuated beyond 15 days.

conclusionsAntihypertensive medication initiation and intensification was associated with a short-term, but not long-term, increased risk of serious fall injuries among older adults.

Indexed as

Accidental FallsAgedAged, 80 and overAge FactorsAntihypertensive AgentsBlood PressureCross-Over StudiesDatabases, FactualDrug Dosage CalculationsDrug Therapy, CombinationFemaleHumansHypertensionLogistic ModelsMaleMedicareAntihypertensive Agentsaccidental fallsagedantihypertensive agentsgeriatrics

Identifiers

PMID27166208
PMCPMC4871744
OpenAlexW2363773630

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.