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49/100

✓ Peer-reviewed alzhub usefulness score 49 out of 100. Clinical safety

Topic: Risk, prevention and care in population studies

This was a retrospective analysis using nationally representative UK general practice population between 1998 and 2018, from electronic health records (Clinical Practice Research Datalink, CPRD, GOLD). Eligible individuals were aged ≥40 years, with a systolic blood pressure 130-179 mmHg, and not previously prescribed antihypertensive treatment. The diagnosis of dementia was based on clinical codes in the electronic health record. Individuals were allocated to the exposure group if they were prescribed at least one antihypertensive medication during a 12-month exposure period. Those who were not prescribed any antihypertensive medication during the exposure period were allocated to the control group. The primary outcome was the first hospitalisation or death from a fall within 10 years of the follow-up period. Secondary outcomes were first hospitalisation or death from hypotension, syncope, and fracture. In a population of 1,219,732 individuals, 23,510 had dementia. Antihypertensive medications were newly prescribed in 4,062/23,510 (17.3%) individuals with dementia and 142,385/1,196,222 (11.9%) individuals without dementia in the 12-month exposure period. In the primary analyses, which adjusted for the propensity score and a previous history of the outcome of interest, antihypertensive treatments were associated with a small increased risk of hospitalisation or death from falls (adjusted hazard ratio [aHR] 1.15, 95% confidence interval [CI] 1.08, 1.22), hypotension (aHR 1.51, 95%CI 1.29, 1.78), syncope (aHR 1.34, 95%CI 1.11, 1.61), but not fracture (aHR 1.05, 95%CI 0.96, 1.15), in individuals with dementia. These findings were consistent across different analytic approaches, including multivariable adjustment, propensity score matching, and inverse probability treatment weighting. In individuals without dementia, the association between antihypertensive treatment and serious adverse events was similar, with a small increased risk of hospitalisation or death from falls (aHR 1.07, 95%CI 1.05, 1.10). However, the absolute fall risk associated with antihypertensive treatment was significantly higher in individuals with dementia (47 per 10,000 individuals per year, 95%CI 26, 70) compared to those without (14 per 10,000 individuals per year, 95%CI 10, 18). The absolute risks of hypotension and syncope with antihypertensive treatment were also higher in the individuals with dementia compared to those without. The main limitation is the possibility of unmeasured co

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Fujiwara, T., Koshiaris, C., Cai, T., Wang, A., Lee, J. J., Lay-Flurrie, S. L., et al. (2025). Associations between falls and other serious adverse events and antihypertensive medication in individuals with dementia: An observational cohort study. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1004731

Vancouver

Fujiwara T, Koshiaris C, Cai T, Wang A, Lee JJ, Lay-Flurrie SL, et al. Associations between falls and other serious adverse events and antihypertensive medication in individuals with dementia: An observational cohort study. PLoS Medicine. 2025. doi:10.1371/journal.pmed.1004731. PMID: 40961130.

BibTeX

@article{fujiwara2025-40961130,
  author  = {Fujiwara, Takeshi and Koshiaris, Constantinos and Cai, Ting and Wang, Ariel and Lee, Joseph Jonathan and Lay-Flurrie, Sarah L and Banerjee, Amitava and Clegg, Andrew Paul and others},
  title   = {{Associations between falls and other serious adverse events and antihypertensive medication in individuals with dementia: An observational cohort study}},
  journal = {PLoS Medicine},
  year    = {2025},
  doi     = {10.1371/journal.pmed.1004731},
  pmid    = {40961130},
  url     = {https://doi.org/10.1371/journal.pmed.1004731}
}

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Key findings

This was a retrospective analysis using nationally representative UK general practice population between 1998 and 2018, from electronic health records (Clinical Practice Research Datalink, CPRD, GOLD).
Eligible individuals were aged ≥40 years, with a systolic blood pressure 130-179 mmHg, and not previously prescribed antihypertensive treatment.
The diagnosis of dementia was based on clinical codes in the electronic health record.
Individuals were allocated to the exposure group if they were prescribed at least one antihypertensive medication during a 12-month exposure period.
Those who were not prescribed any antihypertensive medication during the exposure period were allocated to the control group.

Why it matters

In people with dementia, being newly prescribed blood pressure medication was linked to a small increased risk of hospitalisation or death from falls. This is an observational study, so it cannot show that the medication caused the falls.

Study details

Participants1,219,732
Effect size17.3%; 11.9%; aHR 1.51
Evidence strengthLow

How this study scored 49/100

Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (PLoS Medicine)
Journal's citation record	3 / 4	PLoS Medicine: journal h-index 350 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	4 / 4	1,219,732 participants
Effect reported	3 / 3	Effect reported with a statistic (interval, p-value, ratio or similar)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	1 / 7	Cited 2 times (OpenAlex, 2026-10-10)
Citations per year	0 / 5	0.7 citations a year over 3 year(s) since 2025
Impact for its field and year	2 / 6	Cited 1.1× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	0 / 4	Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author James Peter Sheppard: h-index 31 (OpenAlex, whole career)
Institution's track record	2 / 3	University of Oxford: institution h-index 2,205 (OpenAlex)
Multi-centre collaboration	3 / 3	OpenAlex lists 10 institution(s) in 3 countries
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 40961130)
Free to read	2 / 2	Free to read
Total	49 / 100	—

What each of these 20 components measures, and what this score is not →

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Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

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