title: 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.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Medline and Embase.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Sofie
authors.initials: S
authors.lastname: Jansen
authors.affiliation: 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.
authors.forename: Jaspreet
authors.initials: J
authors.lastname: Bhangu
authors.affiliation: 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.
authors.forename: Sophia
authors.initials: S
authors.lastname: de Rooij
authors.affiliation: Department of Clinical Library, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: Daams
authors.affiliation: Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.
authors.forename: Rose Anne
authors.initials: RA
authors.lastname: Kenny
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Nathalie
authors.initials: N
authors.lastname: van der Velde
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D013575:Syncope
keywords: Cardiovascular disorders; blood pressure; cardiac arrhythmia; falls; syncope