In community-dwelling older adults with hypertension, the association between intensive blood pressure control and adverse outcomes varies depending on the frailty classification tool used, with the Frailty Phenotype tool identifying an increased risk of hospitalization and the Clinical Frailty Scale identifying an increased risk of falls due to under-treatment.

In older adults with weak muscles and limited physical activity, lowering blood pressure too much causes a sudden drop in blood flow to the brain when standing, leading to dizziness and falls. In older adults with multiple health problems and reduced ability to move or think clearly, even normal blood pressure levels can cause falls because their bodies cannot maintain balance or stability, especially if doctors reduce their blood pressure medications to avoid dizziness.