Bradford to lead national research on blood pressure management in older people to prevent falls

Ground-breaking research looking at whether better blood pressure management in older people can reduce the risk of falls and subsequent frailty will be carried out in Bradford.

Funded by the National Institute for Health and Care Research (NIHR), the four-year-long research project will be carried out by a team led by clinical researcher and specialist registrar in geriatric medicine, Dr Oliver Todd, who put the idea forward.

Dr Oliver Todd is an NIHR Academic Clinical Lecturer in Geriatric Medicine in the University of Leeds’s School of Medicine. He will lead this research from the Academic Unit for Ageing and Stroke Research at University of Leeds, which is based at Bradford Institute for Health Research (BIHR), part of Bradford Teaching Hospitals NHS Foundation Trust.

One in three people over 65 will fall this year – often leading to immobility, hospital admissions, poor quality of life and general deconditioning which severely affects the person themselves, their families, carers and puts pressure on the health and social care system.

Dr Todd’s background research showed that the medical guidance for how to manage blood pressure in older people is really limited – both nationally and internationally – yet two out of three people over 65 take blood pressure medication.

“We know that medication for high blood pressure can cause dizziness, and this can lead to some older people falling, ending up in A&E and being admitted to hospital. If people are on too high a dose it can bring their blood pressure too low – leading to dizziness, so that’s why I wanted to research whether better management of this medication can prevent some falls happening,” Dr Todd explained.

“Patients can also often have ‘white coat syndrome’ which means when they go to the GP their blood pressure is higher because of anxiety about going to the doctor and the exertion it takes them to get there.”

This research is being made possible thanks to a huge patient data resource at Bradford which holds approx. 20,000 anonymised blood pressure readings taken over a 24-hour period dating from 1998.

Dr Todd and his team will be linking the blood pressure data with those patients’ health records and using AI to look for patterns of blood pressure – such as if the blood pressure is high or low at certain times of the day or night. Hospitals in Edinburgh and Liverpool will also be involved in this.

“This patient-consented data store is absolute gold and something that few other trusts would have access to,” said Dr Todd. “We also have local falls data to link to – giving us a really in-depth picture of patients’ outcomes.”

As well as using AI, Dr Todd and colleagues will also be talking to patients from many different ethnic groups in Bradford and finding out about their own experiences of blood pressure management.

Dr Todd hopes his work will better inform clinicians and national guidelines so that a patient’s whole health will be taken into consideration when prescribing blood pressure medication and may be measured more frequently so that changes can be made.

“Falls can be devastating, and they become a bigger risk in old age – they rip the confidence out of a person. It may be that, unknowingly, clinicians may be causing patients harm because of over medication for blood pressure.”

Chief Medical Officer at Bradford Teaching Hospitals, Dr Ray Smith said the research could have a far-reaching impact for an ageing population. “I’m very proud of Dr Todd’s success in bringing this exciting new research project to Bradford, it’s gained a lot of interest already as its themes are universal and I very much look forward to seeing what he and his team find out.”

Dr Todd said the time he has already spent at Bradford working with the Frailty research team, including Professor of Geriatric Medicine, Dr Andy Clegg, encouraged and supported him to apply for the NIHR Advanced Fellowship funding.

“Everyone is so excited about this research project; it’s really a dream come true, and we believe it could really transform the way blood pressure is managed in older people worldwide! It’s only possible because Bradford has such a fantastic bank of patient data which staff over the years have actively collected and stored – it’s an amazing resource which will be key to this research.”

Over the course of the next four years Dr Todd will be based fully at Bradford splitting his time between research project and clinical work within the hospital.

Dr Olly Todd and colleagues