Can #bloodpressure treatment be harmful? Our new meta-analysis suggests it is NOT linked to #falls or #fractures but may increase the risk of syncope & acute kidney injury bmj.com/content/372/bm… – see thread @RichardJMcManus @Richard_D_Riley @ebhcmedstats @JulietU_S @drandyclegg 
1/ No meta-analyses of randomised controlled trials to date have quantified the association between blood pressure lowering treatment and specific adverse events such as #falls, #fractures, #syncope (fainting) or acute kidney injury #AKI
2/ In a meta-analysis of 58 randomised controlled trials, including 280,638 participants and an average of 3 years follow-up, there was no evidence of an association between antihypertensive treatment and #falls (primary outcome) or #fractures.
3/ However, over an average 3 years of follow-up, there was an increased risk of mild (hypotension ⬆97%) and more severe adverse events (acute kidney injury ⬆18%, syncope [fainting] ⬆28%) with antihypertensive treatment
4/ For patients with a low absolute risk of adverse events, the harms of antihypertensive treatment are likely to be VERY SMALL. However, for those at ⬆risk of harm due to previous adverse events, these data might be used to inform decisions about whether to start/stop therapy
5/ To make these decisions, we need risk prediction models for the harms of treatment as well as the benefits (e.g. CVD risk calculators and harm risk calculators)
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