Why Heart Failure Patients Face Higher Risk of Falls

Patients with heart failure (HF) are predisposed to falls for a variety of reasons.

Exercise intolerance, respiratory symptoms, reduced cognitive function, and orthostatic hypotension are just a few of the factors that make this population more likely to experience falls.

One study found that HF patients face a greater likelihood of orthopedic fracture, as well.

While research regarding falls in this patient population has been scarce, a team of researchers from the University of Michigan and Indiana University recently published a meta-analysis of HF patient falls.

The authors searched numerous databases for literature published from August 1973 to June 2013 that described falls and fall-related injuries associated with HF.

One of the 4 studies included in their final analysis found that 43% of HF patients had a fall during the study period, compared with 30% in the general older adult community resident population. Another study found that HF patients had 1.86 times greater odds of falling.

Two studies linked benzodiazepines and digoxin to falls. Digoxin is a positive inotrope that improves HF symptoms but increases fall risk through neurological depression and visual changes.

Men were underrepresented in the studies, though they have a similar age-adjusted risk of HF.

The authors called for future longitudinal studies to document the frequency and nature of falls in patients with HF. They also suggested that both disease-specific and treatment-related factors be explored.

Further study can help design improved HF-specific fall prevention interventions. For now, the authors urged clinicians to assess all symptoms carefully, and make patients aware if they have risk factors for falls. They also advised clinicians to manage HF medications carefully.

These findings were published in the Journal of Cardiovascular Nursing.