The Association of Cardiovascular Disorders and Falls: a systematic review
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.
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Coincidental findings of cardiovascular diagnoses such as aortic stenosis or atrial fibrillation may not necessarily be the attributable cause of syncope events.
“Conversely, coincidental findings of cardiovascular diagnoses such as aortic stenosis or atrial fibrillation 377 may not necessarily be the attributable cause of events. 378-380”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [380]
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- Authors
- Jansen, S., Bhangu, J., de Rooij, S., Daams, J., Kenny, R. A., & van der Velde, N.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Trinity College Dublin (IE)
- Corresponding author
- Bhangu, Jaspreet
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 17
- Issue
- 3
- Pages
- 193-199
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W1890797894
- Cited by
- 141
- References
- 33
- Citations by year
- 2026: 12 · 2025: 14 · 2024: 8 · 2023: 19 · 2022: 13 · 2021: 10 · 2020: 10 · 2019: 18 · 2018: 11 · 2017: 16 · 2016: 9 · 2014: 1
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Medical Directors Association (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- falls, cardiovascular disease, older adults, fall risk factors, heart failure, cardiac arrhythmias, orthostatic hypotension, carotid sinus hypersensitivity, vasovagal syncope, postprandial hypotension, arterial stiffness, hypotension, hypertension, coronary artery disease, fall prevention
- MeSH terms
- Accidental Falls, Aged, Aged, 80 and over, Blood Pressure, Cardiovascular Diseases, Humans, Middle Aged, Syncope
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