Alqurain Aymen, Albaharnah Murtada, Al Zayer Samanah, Alanzi Maha, Alblushi Razan, Aleid Rawan, Ashoor Rand, Albahrani Ali, Almahdi Mustafa, Al-Shaibi Samaher, Ameer Luma, Ghosn Sherihan, Algoraini Marwa, Alsubaie Nawal, Alshnbari Afnan, Alomar Fadhel A
Department of Clinical Practice, Faculty of Pharmacy, Northern Border University, Rafha, Saudi Arabia.
Department of Pharmaceutical Care, King Fahad University Hospital, Imam Abdulrahman bin Faisal University, Al Khobar, Saudi Arabia.
Front Pharmacol. 2025 Jul 28;16:1598161. doi: 10.3389/fphar.2025.1598161. eCollection 2025.
Calcium channel blockers, such as amlodipine, are commonly prescribed for hypertension but can cause peripheral edema, often requiring adjunctive frusemide. Concerns exist regarding the potential increase in fall risk, particularly in older populations. However, few studies have assessed the prevalence of amlodipine and frusemide combination (AFC) prescriptions and their association with fall risk factors.
The aims of this study are to determine the prevalence of AFC prescriptions and evaluate their association with fall risk factors in an outpatient cardiology clinic population.
This retrospective, cross-sectional study included patients aged ≥40 years from Al-Qatif Central Hospital's outpatient cardiology clinic (January 2021 -December 2022) prescribed amlodipine. Fall risk factors were identified from literature. The Charlson Comorbidity Index (CCI) was used to estimate 1-year mortality risk. The number of prescribed orthostatic hypotension-inducing drugs (OHDs) and fall-risk increasing drugs (FRIDs) was recorded. Binary logistic regression was performed to determine the association between AFC prescriptions and fall risk factors, adjusting for significant covariates. Results are expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).
Of 3,681 patients, 18%. Were prescribed AFC. AFC patients were older (70 vs. 64 years, < 0.001), had a higher prevalence of diabetes mellitus (64% vs. 44%, < 0.001), anemia (55% vs. 32%, < 0.001), and osteoporosis (51% vs. 28%, < 0.001), and received more OHDs prescriptions (2.8 vs. 1.3, < 0.001) compared to non-AFC patients. Higher CCI scores (OR = 1.51, 95% CI 1.41-1.62) and more OHDs prescriptions (OR = 2.5, 95% CI 2.3-2.7) were significantly associated with AFC prescriptions.
AFC prescriptions are prevalent, and patients prescribed AFC have higher prevalence of fall risk factors. Comprehensive patients assessment is essential to minimize fall risk and related complications.
钙通道阻滞剂，如氨氯地平，常用于治疗高血压，但可引起外周水肿，常需加用呋塞米。人们担心这可能会增加跌倒风险，尤其是在老年人群中。然而，很少有研究评估氨氯地平和呋塞米联合用药（AFC）处方的流行情况及其与跌倒风险因素的关联。
本研究旨在确定AFC处方的流行情况，并评估其与门诊心脏病诊所人群中跌倒风险因素的关联。
这项回顾性横断面研究纳入了2021年1月至2022年12月在卡提夫中心医院门诊心脏病诊所就诊、年龄≥40岁且开具了氨氯地平处方的患者。从文献中确定跌倒风险因素。使用Charlson合并症指数（CCI）来估计1年死亡风险。记录开具的引起体位性低血压的药物（OHD）和增加跌倒风险的药物（FRID）的数量。进行二元逻辑回归以确定AFC处方与跌倒风险因素之间的关联，并对显著的协变量进行调整。结果以调整后的比值比（OR）和95%置信区间（CI）表示。
在3681名患者中，18%的患者开具了AFC处方。AFC组患者年龄更大（70岁对64岁，P<0.001），糖尿病（64%对44%，P<0.001）、贫血（55%对32%，P<0.001）和骨质疏松症（51%对28%，P<0.001）的患病率更高，与非AFC组患者相比，开具的OHD处方更多（分别为2.8种对1.3种，P<0.001）。较高的CCI评分（OR=1.51，95%CI 1.41-1.62）和更多的OHD处方（OR=2.5，95%CI 2.3-2.7）与AFC处方显著相关。
AFC处方很常见，开具AFC处方的患者跌倒风险因素的患病率更高。对患者进行全面评估对于将跌倒风险及相关并发症降至最低至关重要。
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