Advertisement

Drugs & Aging

, Volume 36, Issue 1, pp 95–101 | Cite as

Authors’ Reply to Kahlaee et al: “A Systematic Review and Meta-Analyses of the Association Between Anti-hypertensive Classes and the Risk of Falls Among Older Adults”

  • Ka Keat Lim
  • Hui Ting Ang
  • Yu Heng Kwan
  • Chuen Seng Tan
  • Truls Ostbye
  • Lian Leng Low
Letter to the Editor

We recently performed a systematic review and meta-analyses to examine the associations between antihypertensive classes and three types of fall outcomes: falls, injurious falls and recurrent falls [1]. Past systematic reviews have not shown a consistent association between antihypertensive classes and fall outcomes, and we wanted to take advantage of recent studies with large samples to address this issue. Kahlaee et al. [2] studied a similar topic and sought two clarifications from us: whether we pooled hazard ratios (HRs) and odds ratios (ORs) and whether we considered time–risk analyses (i.e. the association between initiation of antihypertensive medications at various time intervals and falls), similar to the analyses they performed. We would like to respond to their letter here.

Pooling of Effect Size Estimates

We agree that HRs and ORs have somewhat different interpretations. We only pooled estimates with ORs, as stated in the methodology section of our manuscript, and excluded...

Notes

Compliance with Ethical Standards

Conflict of interest

KK Lim, HT Ang, YH Kwan, CS Tan, T Ostbye and LL Low have no conflicts of interest that might be relevant to the contents of this letter.

Funding

No sources of funding were used to prepare this letter.

References

  1. 1.
    Ang HT, Lim KK, Kwan YH, Tan PS, Yap KZ, Banu Z, et al. A systematic review and meta-analyses of the association between anti-hypertensive classes and the risk of falls among older adults. Drugs Aging. 2018;35(7):625–35.CrossRefGoogle Scholar
  2. 2.
    Kahlaee HR, Latt MD, Schneider CR. Association between chronic or acute use of antihypertensive class of medications and falls in older adults. A systematic review and meta-analysis. Am J Hypertens. 2018;31(4):467–79.CrossRefGoogle Scholar
  3. 3.
    Ham AC, Swart KM, Enneman AW, van Dijk SC, Oliai Araghi S, van Wijngaarden JP, et al. Medication-related fall incidents in an older, ambulant population: the B-PROOF study. Drugs Aging. 2014;31(12):917–27.CrossRefGoogle Scholar
  4. 4.
    Hasegawa J, Kuzuya M, Iguchi A. Urinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities. Arch Gerontol Geriatr. 2010;50(1):77–81.CrossRefGoogle Scholar
  5. 5.
    Eriksson S, Gustafson Y, Lundin-Olsson L. Risk factors for falls in people with and without a diagnose of dementia living in residential care facilities: a prospective study. Arch Gerontol Geriatr. 2008;46(3):293–306.CrossRefGoogle Scholar
  6. 6.
    Reid IR, Gamble GD, Grey AB, Black DM, Ensrud KE, Browner WS, et al. beta-Blocker use, BMD, and fractures in the study of osteoporotic fractures. J Bone Miner Res. 2005;20(4):613–8.CrossRefGoogle Scholar
  7. 7.
    Tinetti ME, Han L, Lee DS, McAvay GJ, Peduzzi P, Gross CP, et al. Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Intern Med. 2014;174(4):588–95.CrossRefGoogle Scholar
  8. 8.
    Butt DA, Mamdani M, Austin PC, Tu K, Gomes T, Glazier RH. The risk of falls on initiation of antihypertensive drugs in the elderly. Osteoporos Int J Establ Result Coop Between Eur Found Osteoporos Natl Osteoporos Found USA. 2013;24(10):2649–57.CrossRefGoogle Scholar
  9. 9.
    Gribbin J, Hubbard R, Gladman JR, Smith C, Lewis S. Risk of falls associated with antihypertensive medication: population-based case-control study. Age Ageing. 2010;39(5):592–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Ka Keat Lim
    • 1
  • Hui Ting Ang
    • 2
  • Yu Heng Kwan
    • 1
  • Chuen Seng Tan
    • 3
  • Truls Ostbye
    • 1
  • Lian Leng Low
    • 4
    • 5
  1. 1.Program in Health Services and Systems Research, Duke-NUS Medical SchoolSingaporeRepublic of Singapore
  2. 2.Department of Pharmacy, Faculty of ScienceNational University of SingaporeSingaporeRepublic of Singapore
  3. 3.Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingaporeRepublic of Singapore
  4. 4.Duke-NUS Medical SchoolSingaporeRepublic of Singapore
  5. 5.Department of Family Medicine and Continuing CareSingapore General HospitalSingaporeRepublic of Singapore

Personalised recommendations