A physical therapist determines that a 67-year-old female is at an increased fall risk after being prescribed a new medication that tends to promote postural hypotension. The medication MOST consistent with the described scenario is:

The medication that is most consistent with promoting postural hypotension in this scenario is the ACE inhibitor. ACE inhibitors are commonly used to manage hypertension and heart failure, but they can lead to side effects such as postural hypotension, particularly in older adults. This condition occurs when a person's blood pressure drops significantly upon standing up, leading to dizziness or falls.

In the context of the patient, the combination of advanced age and the new medication increases her fall risk due to the potential for instability while transitioning between sitting and standing positions. This mechanism makes ACE inhibitors particularly relevant in this scenario, as they can affect vascular tone and subsequently blood flow dynamics.

While other classes of medications, such as antiepileptic agents, anticoagulants, and antispasticity agents, may cause other side effects, they are not primarily associated with postural hypotension in the same way that ACE inhibitors are. Therefore, the selection of an ACE inhibitor aligns perfectly with the concern for increased fall risk due to postural changes in this elderly patient.