title: Use of ACE-inhibitors and falls in patients with Parkinson's disease.
abstract: Falls represent a major concern in patients with Parkinson's disease (PD); however, currently acknowledged treatments for PD are not effective in reducing the risk of falling. The aim was to assess the association of use of ACE-inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) with falls among patients with PD. We analysed data of 194 elderly with PD attending a geriatric Day Hospital. Self-reported history of falls that occurred over the last year, as well as use of drugs, including ACEIs and angiotensin II receptor blockers (ARBs) were recorded. The association of the occurrence of any falls with use of ACEIs, and ARBs was assessed by logistic regression analysis. The association between the number of falls and use of ACEIs, and ARBs was assessed according to Poisson regression. In logistic regression, after adjusting for potential confounders, use of ACEIs was associated with a reduced probability of falling over the last year (OR=0.15, 95% CI=0.03-0.81; P=0.028). This association did not vary with blood pressure levels (P for the interaction term=0.528). Also, using Poisson regression, use of ACEIs predicted a reduced number of falls among participants who fell (PR=0.31; 95% CI=0.10-0.94; P=0.039). No association was found between use of ARBs and falls. Our results indicate that use of ACEIs might be independently associated with reduced probability, and a reduced number of falls among patients with PD. Dedicated studies are needed to define the single agents and dosages that might most effectively reduce the risk of falling in clinical practice.
authors.affiliation: Department of Geriatrics, Campus Bio-Medico University, Rome, Italy. Electronic address: lavoralice@gmail.com.
authors.forename: Alice
authors.initials: A
authors.lastname: Laudisio
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopaedics, Catholic University of Medicine, Rome, Italy.
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Lo Monaco
authors.affiliation: Institute of Neurology, Catholic University of Medicine, Rome, Italy.
authors.forename: Maria Caterina
authors.initials: MC
authors.lastname: Silveri
authors.affiliation: Institute of Neurology, Catholic University of Medicine, Rome, Italy.
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Bentivoglio
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopaedics, Catholic University of Medicine, Rome, Italy.
authors.forename: Davide L
authors.initials: DL
authors.lastname: Vetrano
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopaedics, Catholic University of Medicine, Rome, Italy.
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Pisciotta
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopaedics, Catholic University of Medicine, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Brandi
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopaedics, Catholic University of Medicine, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.affiliation: Department of Geriatrics, Neurosciences, and Orthopaedics, Catholic University of Medicine, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zuccalà
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007024:Hypotension, Orthostatic / Q000139:chemically induced; D016015:Logistic Models; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy*; D011336:Probability
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: ACE-inhibitors; Angiotensin II receptor blockers; Elderly; Falls; Parkinson’s disease