Key result
The use of ACEI or ARB in geriatric patients with hip fractures and hypertension was associated with significantly lower 1-year mortality compared to non-users with hypertension (HR 0.230 and HR 0.294, respectively).
Why the study?
Many elderly patients with hip fractures also suffer from hypertension, and the relationship between ACEI or ARB use and hip fracture outcomes remained unclear.
Does the use of ACEI or ARB reduce mortality and improve walking ability in geriatric patients with hip fractures?
Cohort (n=825)
No
Does the use of ACEI or ARB reduce mortality and improve walking ability in geriatric patients with hip fractures?
Hazard Ratio: 0.23 (95% CI 0.137–0.385)
Absolute Event Rate: 12.9% vs 26%
p-value: p=<0.001
In geriatric patients undergoing surgery for hip fractures, the use of ACEI or ARB was associated with significantly lower 1-year mortality and higher rates of independent walking compared to hypertensive non-users.
Should not yet change practice in hypertensive geriatric hip fracture patients; hypothesis-generating pending randomized confirmation.
BACKGROUND: Many elder patients with hip fractures also suffered from hypertension. This study aims to explore the relationship between the use of ACEI or ARB and the outcomes of geriatric hip fractures. METHODS: All the patients were divided into four groups: non-users without hypertension, non-users with hypertension, ACEI users, and ARB users. The outcomes of patients in different groups were compared. LASSO regression and univariable Cox analysis were used for variable screening. Then Cox models and Logistics models were established to identify the relationships between the use of RAAS inhibitors and outcomes. RESULTS: ACER users (p = 0.016) and ARB users (p = 0.027) had a significantly lower survival probability than the non-users with hypertension. Non-users without hypertension, ACEI users, and ARB users may face lower 6-month and 1-year mortalities and higher 6-month and 1-year free walking rates compared with non-users with hypertension. CONCLUSION: Patients with the use of ACEI or ARB may face a better prognosis of hip fractures.
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Chu et al. (2023) conducted a cohort in Geriatric hip fractures (n=825). ACEI or ARB use vs. Non-users with hypertension was evaluated on 1-year mortality (HR 0.230, 95% CI 0.137-0.385, p=<0.001). The use of ACEI or ARB in geriatric patients with hip fractures and hypertension was associated with significantly lower 1-year mortality compared to non-users with hypertension (HR 0.230 and HR 0.294, respectively).
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