Send us a text🧠 Clinical Context:Nursing home residents are fragile fall-prone patients.Starting a new antihypertensive could trigger orthostasis → serious fractures.🧪 Study – VA Nursing Home Cohort:13,000+ residents tracked from 2006–2019, mean age ~78.Examined fracture risk 30 days after starting an antihypertensive.Fractures studied: Pelvic, hip (requiring surgery), humerus, radius, ulna.📈 Outcomes:New antihypertensive initiated → 4.5 serious falls per 100 person-years.No med change → 2.2 events per 100 person-years.That’s >2x risk with a new med.🩺 Clinical Tips:Orthostatic BP check should be done 3–6 minutes after standing (not just 1–2 min).Median best time: 4.5 minutes.Use shared decision-making: Is the BP goal worth a possible hip fracture?Consider deprescribing or "start low, go slow" approach in long-term care.

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