Association of Questionnaire‐Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults
ABSTRACT Therapeutic inertia (TI), or failure to escalate or initiate BP lowering medications when BP is uncontrolled, increases with advancing age and may in part be due to perceived fall risk. This study examined the association of a fall risk assessment, based on patient response to three questio...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | The Journal of Clinical Hypertension |
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| Online Access: | https://doi.org/10.1111/jch.14933 |
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| author | Grant T. Hiura Talar W. Markossian Beatrice D. Probst Katherine Habicht Holly J. Kramer |
| author_facet | Grant T. Hiura Talar W. Markossian Beatrice D. Probst Katherine Habicht Holly J. Kramer |
| author_sort | Grant T. Hiura |
| collection | DOAJ |
| description | ABSTRACT Therapeutic inertia (TI), or failure to escalate or initiate BP lowering medications when BP is uncontrolled, increases with advancing age and may in part be due to perceived fall risk. This study examined the association of a fall risk assessment, based on patient response to three questions administered by trained staff, with uncontrolled BP (≥140/90 mmHg) during a clinic visit and with TI during clinic visits with uncontrolled BP among 13 893 patients age ≥ 65 years corresponding to 41 122 primary care visits. Separate generalized linear mixed effects models were used to examine the association of fall risk (low, moderate, and high) with uncontrolled BP and with TI at a clinic visit after adjustment for demographics, comorbidities, and total number of visits. Baseline mean age was 73.0 years (standard deviation [SD] 5.6), 43.3% were men and questionnaire‐assessed fall risk severity was low in 73.6%, moderate in 14.3%, and high in 12.2%. Compared to low fall risk, the adjusted odds of uncontrolled BP during a clinic visit were 0.97 (95% CI: 0.89, 1.06) and 0.90 (95% CI: 0.82, 0.98) with moderate and high fall risk, respectively. In contrast, adjusted odds of TI during a clinic visit with BP ≥ 140/90 mmHg was 1.16 (95% CI: 1.01, 1.34) and 1.30 (95% CI: 1.11, 1.52) with moderate and high fall risk, respectively, compared to low fall risk. These findings suggest that perceived fall risk severity may be one of several factors that influence hypertension management in older adults. |
| format | Article |
| id | doaj-art-2cb05fe26e9540f0ac79fb47450a71aa |
| institution | Kabale University |
| issn | 1524-6175 1751-7176 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | The Journal of Clinical Hypertension |
| spelling | doaj-art-2cb05fe26e9540f0ac79fb47450a71aa2025-01-31T05:38:37ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-01-01271n/an/a10.1111/jch.14933Association of Questionnaire‐Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older AdultsGrant T. Hiura0Talar W. Markossian1Beatrice D. Probst2Katherine Habicht3Holly J. Kramer4Stritch School of Medicine Loyola University Chicago Maywood Illinois USADepartment of Public Health Sciences Loyola University Chicago Maywood Illinois USAStritch School of Medicine Loyola University Chicago Maywood Illinois USALoyola Physician Partners Loyola University Chicago Maywood Illinois USADepartment of Public Health Sciences Loyola University Chicago Maywood Illinois USAABSTRACT Therapeutic inertia (TI), or failure to escalate or initiate BP lowering medications when BP is uncontrolled, increases with advancing age and may in part be due to perceived fall risk. This study examined the association of a fall risk assessment, based on patient response to three questions administered by trained staff, with uncontrolled BP (≥140/90 mmHg) during a clinic visit and with TI during clinic visits with uncontrolled BP among 13 893 patients age ≥ 65 years corresponding to 41 122 primary care visits. Separate generalized linear mixed effects models were used to examine the association of fall risk (low, moderate, and high) with uncontrolled BP and with TI at a clinic visit after adjustment for demographics, comorbidities, and total number of visits. Baseline mean age was 73.0 years (standard deviation [SD] 5.6), 43.3% were men and questionnaire‐assessed fall risk severity was low in 73.6%, moderate in 14.3%, and high in 12.2%. Compared to low fall risk, the adjusted odds of uncontrolled BP during a clinic visit were 0.97 (95% CI: 0.89, 1.06) and 0.90 (95% CI: 0.82, 0.98) with moderate and high fall risk, respectively. In contrast, adjusted odds of TI during a clinic visit with BP ≥ 140/90 mmHg was 1.16 (95% CI: 1.01, 1.34) and 1.30 (95% CI: 1.11, 1.52) with moderate and high fall risk, respectively, compared to low fall risk. These findings suggest that perceived fall risk severity may be one of several factors that influence hypertension management in older adults.https://doi.org/10.1111/jch.14933agingblood pressurefallshypertensioninertia |
| spellingShingle | Grant T. Hiura Talar W. Markossian Beatrice D. Probst Katherine Habicht Holly J. Kramer Association of Questionnaire‐Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults The Journal of Clinical Hypertension aging blood pressure falls hypertension inertia |
| title | Association of Questionnaire‐Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults |
| title_full | Association of Questionnaire‐Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults |
| title_fullStr | Association of Questionnaire‐Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults |
| title_full_unstemmed | Association of Questionnaire‐Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults |
| title_short | Association of Questionnaire‐Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults |
| title_sort | association of questionnaire assessed fall risk with uncontrolled blood pressure and therapeutic inertia among older adults |
| topic | aging blood pressure falls hypertension inertia |
| url | https://doi.org/10.1111/jch.14933 |
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