{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:15:39Z","timestamp":1788286539158,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["1RF1AG045441"],"award-info":[{"award-number":["1RF1AG045441"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little evidence exists about the comparative effects of first\u2010line antihypertensive medications (i.e., renin\u2010angiotensin\u2010aldosterone converting enzyme inhibitors (RAASi), amlodipine, or thiazide diuretics) in older adults with limited life expectancy. We compared the rates of injurious falls and short\u2010term cardiovascular events between different first\u2010line antihypertensive medication classes in adults receiving care in nursing homes (NH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective cohort of Medicare fee\u2010for\u2010service beneficiaries receiving care in NHs. Patients newly dispensed first\u2010line antihypertensive medications were identified using Part D claims (2015\u20132018) and linked with clinical assessments (i.e., Minimum Data Set). Fall\u2010related injuries (FRI), hip fractures, and major adverse cardiac events (MACE) outcomes were identified using hospitalization claims. Patients were followed from the date of antihypertensive dispensing until the occurrence of outcomes, death, disenrollment, or 6\u2010month follow\u2010up. Inverse\u2010probability\u2010of\u2010treatment\u2010weighted (IPTW) cause\u2010specific hazards regression models were used to compare outcomes between patients who were new users of RAASi, amlodipine, or thiazides.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our cohort included 16,504 antihypertensive users (RAASi,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099574; amlodipine,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095049; thiazide,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091881). Mean age was 83.5\u2009years (\u00b1\u20098.2), 70.6% were female, and 17.2% were non\u2010white race. During a mean follow\u2010up of 5.3\u2009months, 326 patients (2.0%) experienced an injurious fall, 1590 (9.6%) experienced MACE, and 2123 patients (12.9%) died. The intention\u2010to\u2010treat IPTW hazard ratio (HR) for injurious falls for amlodipine (vs RAASi) use was 0.85 (95% confidence interval (CI) 0.66\u20131.08) and for thiazides (vs RAASi) was 1.22 (95% CI 0.88\u20131.66). The rates of MACE were similar between those taking anti\u2010hypertensive medications. Thiazides were discontinued more often than other classes; however, inferences were largely unchanged in as\u2010treated analyses. Subgroup analyses were generally consistent.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Older adults with limited life expectancy experience similar rates of injurious falls and short\u2010term cardiovascular events after initiating any of the first\u2010line antihypertensive medications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18702","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T12:14:55Z","timestamp":1701778495000},"page":"682-692","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Fall risk and cardiovascular outcomes of\n                    <scp>first\u2010line<\/scp>\n                    antihypertensive medications in nursing home residents"],"prefix":"10.1111","volume":"72","author":[{"given":"Sarah D.","family":"Berry","sequence":"first","affiliation":[{"name":"Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research and Department of Medicine  Roslindale Massachusetts USA"},{"name":"Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1122-0071","authenticated-orcid":false,"given":"Kaleen","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice &amp; Center for Gerontology Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoojin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice &amp; Center for Gerontology Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice &amp; Center for Gerontology Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7290-6838","authenticated-orcid":false,"given":"Dae H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research and Department of Medicine  Roslindale Massachusetts USA"},{"name":"Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darae","family":"Ko","sequence":"additional","affiliation":[{"name":"Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research and Department of Medicine  Roslindale Massachusetts USA"},{"name":"Section of Cardiovascular Medicine Boston Medical Center and Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas P.","family":"Kiel","sequence":"additional","affiliation":[{"name":"Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research and Department of Medicine  Roslindale Massachusetts USA"},{"name":"Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Daielo","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice &amp; 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