Aurelian Sorina Maria, Pîslaru Anca Iuliana, Albișteanu Sabinne-Marie, Dragoescu Sonia, Gîdei Sandra Monica, Ilie Adina Carmen, Ștefăniu Ramona, Oancea Corina, Prada Ana-Gabriela, Alexa Ioana Dana
Clinic of Geriatrics, Hospital of Chronic Diseases "Sf. Luca", Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 041915 Bucharest, Romania.
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
J Clin Med. 2025 Jun 27;14(13):4570. doi: 10.3390/jcm14134570.
Falls are a major cause of morbidity and mortality among older adults and are influenced by comorbidities and polypharmacy. Cardiovascular diseases (CVDs) and their associated treatments are particularly prevalent in this population and may contribute to fall risk. The objectives of this study were to examine the association between cardiovascular pharmacotherapy and fall risk in older adults and to identify potential preventive strategies. This observational case-control study was conducted between June and December 2024 and included 200 participants aged over 55 years who provided informed consent. Participants were assessed using the Downton Fall Risk Index and divided into two equal groups, with those at high risk of falling and controls. All participants underwent a comprehensive geriatric assessment, including anamnesis, clinical evaluation, and laboratory testing focused on cardiovascular risk factors. The prevalence of CVD and the use of specific cardiovascular medications were analyzed. Patients at high risk of falling showed significant differences compared to the control group in several parameters, including systolic blood pressure (SBP: 140.41 mmHg vs. 151.28 mmHg, = 0.001), ankle brachial index (left ABI: 1.09 vs. 1.15., = 0.033), and presence of cardiovascular diseases ( = 0.001), as well as total cholesterol ( = 0.005) and triglyceride levels ( = 0.047). Certain cardiovascular medications were significantly associated with increased fall risk, including spironolactone (OR = 4.10, = 0.001), beta-blockers (OR = 1.88, = 0.031), and calcium channel blockers (OR = 2.05, = 0.014), especially in combination with one another. Additional risk factors included frailty, cognitive impairment, diabetes, and neurological or osteoarticular conditions. Interventions such as medication review, deprescribing, and dosage adjustments may help reduce fall risk without compromising cardiovascular disease management. Cardiovascular diseases and related pharmacotherapy are significantly associated with an increased risk of falls in older adults. Regular medication reviews, deprescribing where appropriate, and individualized treatment plans may help minimize fall risk while maintaining the effective cardiovascular care of this vulnerable population.
跌倒是老年人发病和死亡的主要原因，受合并症和多重用药的影响。心血管疾病（CVDs）及其相关治疗在该人群中尤为普遍，可能会增加跌倒风险。本研究的目的是探讨老年人心血管药物治疗与跌倒风险之间的关联，并确定潜在的预防策略。这项观察性病例对照研究于2024年6月至12月进行，纳入了200名年龄超过55岁且签署知情同意书的参与者。使用唐顿跌倒风险指数对参与者进行评估，并将其分为两组，即跌倒高风险组和对照组。所有参与者均接受了全面的老年综合评估，包括问诊、临床评估以及针对心血管危险因素的实验室检查。分析了心血管疾病的患病率以及特定心血管药物的使用情况。跌倒高风险组患者与对照组相比，在几个参数上存在显著差异，包括收缩压（SBP：140.41 mmHg对151.28 mmHg，P = 0.001）、踝臂指数（左侧ABI：1.09对1.15，P = 0.033）、心血管疾病的存在情况（P = 0.001），以及总胆固醇（P = 0.005）和甘油三酯水平（P = 0.047）。某些心血管药物与跌倒风险增加显著相关，包括螺内酯（OR = 4.10，P = 0.001）、β受体阻滞剂（OR = 1.88，P = 0.031）和钙通道阻滞剂（OR = 2.05，P = 0.014），尤其是相互联合使用时。其他风险因素包括虚弱、认知障碍、糖尿病以及神经或骨关节疾病。药物审查、减药和剂量调整等干预措施可能有助于降低跌倒风险，同时不影响心血管疾病的管理。心血管疾病和相关药物治疗与老年人跌倒风险增加显著相关。定期进行药物审查、在适当情况下减药以及制定个体化治疗方案，可能有助于在维持对这一脆弱人群有效心血管护理的同时，将跌倒风险降至最低。
