Beta Blockers Linked To Increased Risk of Falls Interview with:
Dr. Nathalie van der Velde

Erasmus MC
The Netherlands What is the background for this study? What are the main findings?

Response: In older persons, falls are the leading cause of injuries and often an adverse-drug reaction is involved. By lowering medication-related fall risk, loss of quality of life, institutionalization, and death can be prevented. Nevertheless, for optimal medication-withdrawal in clinical practice, better understanding of medication-related fall risk is essential, especially for the group of cardiovascular drugs, as previous studies showed contradictory results. Therefore, the objective of our study was to assess whether specific drug characteristics determine beta-blocker related fall risk, a frequently prescribed cardiovascular drug.

Our study showed that fall risk was increased in users of non-selective beta-blockers. This was not the case for overall use of beta-blockers or other drug characteristics (lipid solubility, intrinsic sympathetic activity and CYP2D enzyme metabolism). What should clinicians and patients take away from your report?

Response: In clinical practice, beta-blockers have been shown effectivity for a variety of cardiovascular indications. Though, fall risk should be considered when prescribing a beta-blocker in the older age group. When prescribing a beta-blocker, selection of the drug of choice preferably co-depends on possible drug-characteristic dependent adverse events. A selective beta-blocker as therefore preferable in older persons at risk of falls. What recommendations do you have for future research as a result of this study?

Response: Our findings need to be confirmed in further studies. Future studies on drug-related fall risk should include analysis of effects of drug-characteristics. Thank you for your contribution to the community.


Beta-Blocker Use and Fall Risk in Older Individuals; Original Results From Two Studies With Meta-Analysis
Annelies C Ham 1 , Suzanne C van Dijk 1 , Karin M A Swart 2 , Anke W Enneman 1 , Nikita L van der Zwaluw 3 , Elske M Brouwer-Brolsma 3 , Natasja M van Schoor 2 , M Carola Zillikens 1 , Paul Lips 2, 4 , Lisette C P G M de Groot 3 , Albert Hofman 5, 6 , Renger F Witkamp 3 , André G Uitterlinden 1, 5 , Bruno H Stricker 1, 5 , Nathalie van der Velde 1, 7

PubMed: 28589543
DOI: 10.1111/bcp.13328

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Last Updated on June 19, 2017 by Marie Benz MD FAAD