Every one knows the dangers of hypertension. We are repeatedly told that the “silent killer” leads to heart attacks, strokes, kidney disease, blindness and dementia, to name just some of the scary consequences of uncontrolled high blood pressure.

What we are not told, however, is that aggressive treatment with medications may also pose risks. A new study in JAMA Internal Medicine (online, Feb. 24, 2014) found that older people treated with moderate to high-dose antihypertensive medications were at 30 to 40 percent increased risk of dangerous falls.

Nearly 5,000 Medicare beneficiaries were tracked for three years. Most (86 percent) were taking at least one drug for high blood pressure. Nearly one third were taking two or three different kinds blood pressure pills simultaneously. Older people who fell experienced joint dislocations, hip fractures and major head injuries. In many cases these accidents led to disability or even death.

One reader shared her own experience: “I am taking amlodipine (Norvasc), carvedilol (Coreg) and losartan (Cozaar) for high blood pressure. These drugs have me feeling bad. Last September I fell and completely passed out. I had a broken pelvis, broken rib and a concussion. I was hospitalized and had to spend two months in rehab. If this happens again it is curtains for me.”

A fall like this is a red flag for another accident. The researchers found that the risk for a second serious fall more than doubles in patients taking multiple blood pressure medications.

Balancing the benefits of blood pressure medicine against their risks is a delicate proposition. That is why new guidelines for treating high blood pressure have raised the bar. Instead of aiming for 140/90 in those over 60, experts have determined that physicians should only treat hypertension when the upper number (systolic blood pressure) exceeds 150 (JAMA, Feb. 5, 2014).

As long as side effects such as dizziness, drowsiness or unsteadiness are not a problem, the benefits of treatment may well outweigh the risks. When people find that their quality of life is affected by their medicine, however, they may need to discuss their treatment program with the prescribing physician.

Another reader shared this experience with a beta blocker blood pressure drug: “I have been on metoprolol for years and before that it was Toprol. I have asked numerous doctors why I have experienced so many symptoms. I’ve had fatigue, depression, palpitations, dizziness, difficulty breathing, coughing, cold feet and hands, light headedness, poor coordination, and many other problems. I have asked a number of doctors to change my blood pressure medicine but they all seem to just laugh it off. Am I wrong in wanting to change?”

Beta blockers like atenolol, metoprolol and propranolol can cause such symptoms. The new blood pressure guidelines specifically reserve beta blockers for the last line of therapy, only after other approaches have failed. Never stop such drugs suddenly, though, as doing so can trigger chest pain, irregular heart rhythms or even a heart attack.

For other ways to control hypertension, including many non-drug options, we offer our book, Best Choices from The People’s Pharmacy (online at www.PeoplesPharmacy.com).

 

Join Over 52,000 Subscribers at The People's Pharmacy

Each week we send two free email newsletters with breaking health news, prescription drug information, home remedies and a preview of our award-winning radio show. Join our mailing list and get the information you need to make confident choices about your health.

  1. mmv
    Reply

    Years ago, my doctor insisted I had high blood pressure and put me on Verapamil. He decided this after taking one reading at one office visit. At the time, I had been using Sudafed for repeated bouts of sinus congestion. He never asked if I was taking any medication; over the counter or otherwise. My pressure at that visit was 154/92.
    Once my sinuses cleared and I stopped the Sudafed, my BP went back to its normal (for me) 90/60 and I stopped taking the Verapamil. He is no longer my doctor. We need to be more diligent in orchestrating our own medical care. I know doctors are very busy and can easily make a mistake. Since that time I make a point of asking questions, repeating back what I hear to be sure and if the doctor gets upset with me I ask for my records so I can find someone that will take the time to explain my care to me.
    Your programs encourage me to ask the questions. The answers may lead to different approaches and I also think my current doctor appreciates that we can speak openly about my care.

  2. RM
    Reply

    My father lived to be 92. The last months of his life he took high blood pressure medicine. He had a number of falls after that. He took several different medicines and they all had some side effects.
    The Doctor had put him on baby aspirin some years earlier, & eventually after quite some time he developed ulcers. He never recovered from the ulcers. Later I gave him fish oil several times a week to thin his blood.
    Today, looking back I think he would have been better off without any of the medications, except the lasik. (not sure of the spelling) He began a rapid decline after he first started the lasik, losing a lot of weight.
    They finally reduced the dose which made it barely tolerable. They also had him on antidepressants for a while, possibly to help him sleep. These would cause constipation when taking them.
    The doctors never mentioned and probably didn’t know that it takes a full six months to wean yourself off this medicine, otherwise you won’t be able to sleep and will have panic attacks when you stop.

  3. Torrence
    Reply

    I have been on just about every BP meds there is and found out I don’t even have high blood pressure. HOW? I was taking 1mg of CLONIDINE daily at night. Before I started this pill I was a waker almost every day. One day, at the Mall, I almost passed out and thought I was having a heart attack. It turns out the pill was making my BP so low it was causing the problem. The doctor told me to just take a half of pill. I still could not walk like I did before the pill. The I went to just a quarter of the pill on my own and found out it still had a small effect on me. BUT, I went to the doctor for a follow up. At this time I was taking the quarter pill every other day My wife was first before me to see the doctor. So, I was in the waiting room for over an hour.
    When I went in my BP was checked and it was 122/80. So, I decided that my BP most of the time was WHITE COAT at the doctors. I have quit the pill all together and NOW I don’t get fainting spells when I exercise. A quarter of a pill like that is nothing, so I decided if it [the quarter] was still lowering my BP to far, I didn’t need it at all. I like the idea of 150/90 BP. I can live with that and will cut back on salt and make sure I do my exercises. THINK ABOUT IT!

  4. rh
    Reply

    My sister has slightly elevated blood pressure that became much higher each time it was taken in the doctor’s office (White Coat Syndrome.) He threatened to put her on blood pressure medication but she was refusing.
    I am an RN and have repeatedly advised her not to take any medication that is not 100% absolutely necessary. I sent her the article from The People’s Pharmacy regarding eating beets to reduce blood pressure. She has been eating a serving of beets daily for the past several months and monitoring her blood pressure at home. After eating the beets for about a week, she reported to me that her blood pressure returned to normal and stays that way as long as she eats the beets.

  5. Rodica
    Reply

    Hi,
    I think is wars than what you mentioned for older people. My husband who is now 72 was put on Amlodipine-Norvasc some 4 years ago and since then he is going down mentally and got among a lot of others negative effects of that drug, some v. strange ones like becoming uncaring, losing feelings and sensibility and of course confusion, being unfocused and irrational. And even worse, it looks like this drug, (v. cheap made in India) has addictive power because my husband, obsessed and hypochondriac believe that only this drug is really working for him and never really reported his side effects which are gradually and v. subtle ?!
    In order to be kept on it even some honest doctors tried to replace it he boycotted the new ones and pretend that it make him sick ?! The same think with the supplements, I tried to convince him would be the best option. As somebody already mentioned the doctors basically ignore and don’t care about side effects that would be a conflict of interest for them and whoever manufacture the drugs. He is sort of brain washed and educated to blindly trust doctors and don’t dare to question and challenge their decisions ?!

  6. frenagd
    Reply

    Yep, I used to have a care home and we hated it when doctors wanted to change meds on one of our elders, because we knew we’d be picking them up off the floor. Family members need to be very pro-active on this issue. I used to personally negotiate with people’s doctors over whether a new med would cause more problems than it was supposed to fix…..

  7. Brooks
    Reply

    Are the symptoms the result of low blood pressure or the effect of the medicine?

  8. Jan S.
    Reply

    I have had neuropathy for some years and when balance became really bad, at age 77, this was expected with PN. But your newspaper article and this one make me wonder. Dr’s seem thrilled when they see 115/68 or lower but I am sleepy all the time, no energy, seriously having trouble with balance, already over a year ago, asked the dr. to cut my Rx (Cozaar), in half… and felt much better. Maybe it’s time to lower it again. I also take Cardizem for my heart. Thanks for this article; I will ask about it.

  9. et
    Reply

    My husband is 89 yo. on atenonol for 14 years. Was put on enalopril high doses along with atenonol for chest pain, that went away. Now six years later after adding the enalopril, my husband is falling in house, sleeping all day, up at nite, and memory confusion. Doctor will not admit that any medication will cause this. Also had him on high dose statin, until it was pulled off market and said he would not take him off unless he got the notice. It is impossible to change his doctor at this age. What is a person to do?

What Do You Think?

Share your thoughts with others, but be mindful of protecting your own and others' privacy. Not all comments will be posted. Advice from web visitors is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. In posting a comment, you agree to our commenting policy and website terms and conditions.