Geriatric syndrome of falls in comorbid patients: paradox of normotension in the elderly

Background. Falls as geriatric syndrome in elderly age are associated with high health risks, including serious injury, prolonged hospital stays, and medical and follow-up costs. The prevalence of falls in comorbid elderly patients without hypertension remains uncertain.

Aim. To study the incidence of falls in the comorbid elderly with or without hypertension.

Materials and methods. The study included 5240 outpatients aged 60 and over with three or more chronic diseases treated at Moscow polyclinics with verified diagnoses according to medical records in 2015–2018. The exclusion criteria were acute illness, exacerbation of chronic diseases, disease decompensation, severe sensory impairment and dementia. Student's t-criterion was used to compare quantitative variables between groups and Fisher's exact test was used to compare binary variables.

Results. The age of study participants was 71.0 ± 0.1 years, 72.4% – women. The vast majority of patients (99.3%, n=5202) has been diagnosed with arterial hypertension or essential hypertension, and 0.7% of patients (n=38) had no such diagnoses. The incidence of falls in hypertensive patients was 16.4% (n=857), while 42.1% (n=16) of patients without hypertension reported falls (p=0.00018; odds ratio 3.69; 95% confidence interval 1.80–7.38).

Conclusion. The paradox of the greater frequency of falls in the group of elderly patients who experienced no blood pressure elevation episodes compared with hypertensive patients has not been fully understood yet and can indicate that the risk of falls in patients who experienced no blood pressure elevation is higher; however, further research is required.