The association between STOPPFall medication use and orthostatic hypotension in community-dwelling older people

Abstract Introduction Fall-risk-increasing drugs (FRIDs), identified by the Screening Tool of Older Persons Prescriptions in older adults with high fall risk (STOPPFall), may increase fall risk by causing orthostatic hypotension (OH). This study investigates the association between STOPPFall medication use and OH in community-dwelling older people ≥65 years using data from The Irish Longitudinal Study on Ageing (TILDA). Methods Orthostatic blood pressure (BP) was measured by active stand using a Finometer. STOPPFall medications were recorded at TILDA Waves 1 10.6% (159/1499) were prescribed ≥2 STOPPFall medications. Prescription of ≥2 STOPPFall medications was independently associated with delayed BP recovery odds ratio (OR) 1.88 (95% CI 1.25–2.82); P = .003, ‘any OH’ OR 1.48 (95% CI 1.00–2.18); P = .048, and classical OH OR 2.07 (95% CI 1.13–3.78); P = .018, and was associated with significantly lower sBP at 30- coefficient −7.91(95% CI −10.22 to −5.60); P .001, 60- coefficient −5.55(95% CI −7.86 to −3.24); P .001, 90- coefficient −2.63(95% CI −4.95 to −0.32); P = .026, and 120 seconds coefficient − 3.67(95% CI −5.98 to −1.36); P = .002. Increasing STOPPFall medication at Wave 3 was associated with significantly lower sBP at 30 seconds coefficient −3.22(95% CI −5.73 to −0.72); P = .012. Conclusion Prescription of ≥2 STOPPFall medications was associated with significantly delayed BP recovery post-stand and OH. This highlights that rationalising STOPPFall medications is indicated in older people with OH.