Sofie Jansen1, Jaspreet Bhangu2, Sophia de Rooij3, Joost Daams4, Rose Anne Kenny5, Nathalie van der Velde1. 1. Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. 2. Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland. Electronic address: jaspreetbhangu@gmail.com. 3. Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; University Centre for Geriatric Medicine, University Medical Center Groningen, Groningen, the Netherlands. 4. Department of Clinical Library, Academic Medical Center, University of Amsterdam, the Netherlands. 5. Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.
Abstract
OBJECTIVE: Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care. DESIGN: Systematic review. DATA SOURCES: Medline and Embase. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: studies addressing persons aged 50 years and older that described cardiovascular risk factors for falls. Key search terms for cardiovascular abnormalities included all synonyms for the following groups: structural cardiac abnormalities, cardiac arrhythmia, blood pressure abnormalities, carotid sinus hypersensitivity (CSH), orthostatic hypotension (OH), vasovagal syncope (VVS), postprandial hypotension (PPH), arterial stiffness, heart failure, and cardiovascular disease. Quality of studies was assed using the Newcastle-Ottawa Scale. RESULTS: Eighty-six studies were included. Of studies that used a control group, most consistent associations with falls were observed for low blood pressure (BP) (4/5 studies showing a positive association), heart failure (4/5), and cardiac arrhythmia (4/6). Higher prevalences of CSH (4/6), VVS (2/2), and PPH (3/4) were reported in fallers compared with controls in most studies, but most of these studies failed to show clear association measures. Coronary artery disease (6/10), orthostatic hypotension (9/25), general cardiovascular disease (4/9), and hypertension (7/25) all showed inconsistent associations with falls. Arterial stiffness was identified as an independent predictor for falls in one study, as were several echocardiographic abnormalities. CONCLUSION: Several cardiovascular associations with falls were identified, including low BP, heart failure, and arrhythmia. These results provide several angles for optimizing fall-preventive care, but further work on standard definitions, as well as the exact contribution of individual risk factors on fall incidence is now important to find potential areas for preventive interventions.
OBJECTIVE:Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care. DESIGN: Systematic review. DATA SOURCES: Medline and Embase. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: studies addressing persons aged 50 years and older that described cardiovascular risk factors for falls. Key search terms for cardiovascular abnormalities included all synonyms for the following groups: structural cardiac abnormalities, cardiac arrhythmia, blood pressure abnormalities, carotid sinus hypersensitivity (CSH), orthostatic hypotension (OH), vasovagal syncope (VVS), postprandial hypotension (PPH), arterial stiffness, heart failure, and cardiovascular disease. Quality of studies was assed using the Newcastle-Ottawa Scale. RESULTS: Eighty-six studies were included. Of studies that used a control group, most consistent associations with falls were observed for low blood pressure (BP) (4/5 studies showing a positive association), heart failure (4/5), and cardiac arrhythmia (4/6). Higher prevalences of CSH (4/6), VVS (2/2), and PPH (3/4) were reported in fallers compared with controls in most studies, but most of these studies failed to show clear association measures. Coronary artery disease (6/10), orthostatic hypotension (9/25), general cardiovascular disease (4/9), and hypertension (7/25) all showed inconsistent associations with falls. Arterial stiffness was identified as an independent predictor for falls in one study, as were several echocardiographic abnormalities. CONCLUSION: Several cardiovascular associations with falls were identified, including low BP, heart failure, and arrhythmia. These results provide several angles for optimizing fall-preventive care, but further work on standard definitions, as well as the exact contribution of individual risk factors on fall incidence is now important to find potential areas for preventive interventions.
Authors: Taliesin E Ryan-Atwood; Mieke Hutchinson-Kern; Jenni Ilomäki; Michael J Dooley; Susan G Poole; Carl M Kirkpatrick; Elizabeth Manias; Biswadev Mitra; J Simon Bell Journal: Drugs Aging Date: 2017-08 Impact factor: 3.923
Authors: Joshua I Barzilay; Barry R Davis; Sara L Pressel; Alokananda Ghosh; Rachel Puttnam; Karen L Margolis; Paul K Whelton Journal: Curr Cardiol Rep Date: 2017-09 Impact factor: 2.931
Authors: José G Rivera-Chávez; Jorge L Torres-Gutiérrez; Alejandra Regalado-Villalobos; César A Moreno-Cervantes; Sara Luna-Torres Journal: Arch Cardiol Mex Date: 2021
Authors: Bob van de Loo; Lotta J Seppala; Nathalie van der Velde; Stephanie Medlock; Michael Denkinger; Lisette Cpgm de Groot; Rose-Anne Kenny; Frank Moriarty; Dietrich Rothenbacher; Bruno Stricker; André Uitterlinden; Ameen Abu-Hanna; Martijn W Heymans; Natasja van Schoor Journal: J Gerontol A Biol Sci Med Sci Date: 2022-07-05 Impact factor: 6.591
Authors: Vanessa Cristina Alves; Weslen Carlos Junior de Freitas; Jeferson Silva Ramos; Samantha Rodrigues Garbis Chagas; Cissa Azevedo; Luciana Regina Ferreira da Mata Journal: Rev Lat Am Enfermagem Date: 2017-12-21
Authors: Heidi Lehtola; Antti Palomäki; Pirjo Mustonen; Päivi Hartikainen; Tuomas Kiviniemi; Henri Sallinen; Ilpo Nuotio; Antti Ylitalo; K E Juhani Airaksinen; Juha Hartikainen Journal: Neurol Clin Pract Date: 2018-08