What risk might increase for an older adult starting losartan (Cozaar) for hypertension?

Losartan is an angiotensin II receptor antagonist commonly used to manage hypertension. When considering the risks associated with this medication, particularly in older adults, one significant concern is the potential for falls. Older adults are generally at an increased risk of falls due to factors such as age-related changes in balance, strength, and coordination, as well as the effects of medications that may impact these functions.

In the case of losartan, there are several mechanisms that can contribute to an increased risk of falls. First, losartan may cause orthostatic hypotension in some individuals, which is a drop in blood pressure upon standing. This condition can lead to dizziness or lightheadedness, increasing the likelihood of losing balance and falling. Additionally, older adults may have other comorbidities and are often taking multiple medications that can further contribute to dizziness and impaired balance.

While other choices may reflect concerns in different contexts or populations, the association between antihypertensive agents like losartan and falls, driven by the potential for dizziness and orthostatic hypotension, makes this option particularly relevant for older adults starting on this medication.