@article{ref1,
title="Beta-blocker use and fall risk in older individuals; original results from two studies with meta-analysis",
journal="British journal of clinical pharmacology",
year="2017",
author="Ham, Annelies C. and van Dijk, Suzanne C. and Swart, Karin M. A. and Enneman, Anke W. and van der Zwaluw, Nikita L. and Brouwer-Brolsma, Elske M. and van Schoor, Natasja M. and Carola Zillikens, M. and Lips, Paul and de Groot, Lisette C. P. G. M. and Hofman, Albert and Witkamp, Renger F. and Uitterlinden, Andre G. and Stricker, Bruno H. and van der Velde, Nathalie",
volume="83",
number="10",
pages="2292-2302",
abstract="AIMS: To investigate the association between use of beta-blockers and beta-blocker characteristics - selectivity, lipid solubility, intrinsic sympathetic activity (ISA), and CYP2D6 enzyme metabolism - and fall risk. <br><br>METHODS: Data from two prospective studies were used, including community-dwelling individuals, N=7,662 (the Rotterdam Study) and 2,407 (B-PROOF), all aged ≥55 years. Fall incidents were recorded prospectively. Time-varying beta-blocker use was determined using pharmacy dispensing records. Cox proportional hazard models adjusted for age and sex were applied to determine the association between beta-blocker use, their characteristics - selectivity, lipid solubility, ISA, and CYP2D6 enzyme metabolism - , and fall risk. The results of the studies were combined using meta-analyses. <br><br>RESULTS: In total 2,917 participants encountered a fall during a total follow-up time of 89,529 years. Meta-analysis indicated no association between use of any beta-blocker, compared to non-use, and fall risk, HR=0.97 (95%CI 0.88; 1.06). Neither was use of a selective beta-blocker associated with fall risk, HR=0.92 (95%CI 0.83; 1.01). Use of a non-selective beta-blocker was associated with an increased fall risk, HR=1.22 (95%CI 1.01; 1.48). Other beta-blocker characteristics including lipid solubility and CYP2D6 enzyme metabolism were not associated with fall risk. <br><br>CONCLUSION: Our study suggests that use of a non-selective beta-blocker, contrary to selective beta-blockers, is associated with an increased fall risk in an older population. In clinical practice, beta-blockers have been shown effective for a variety of cardiovascular indications. Though, fall risk should be considered when prescribing a beta-blocker in this age group, and the pros and cons for beta-blockers classes should be taken into consideration.<br><br>This article is protected by copyright. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0306-5251",
doi="10.1111/bcp.13328",
url="http://dx.doi.org/10.1111/bcp.13328"
}