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Patients with AF, history of falls at increased mortality risk
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Patients with atrial fibrillation are more likely than those without AF to have a history of falls, and patients with both AF and a history of falls are at increased risk for mortality, according to study data published in the American Journal of Cardiology.
Wesley T. O’Neal, MD, MPH, of the Wake Forest School of Medicine, Winston-Salem, North Carolina, and colleagues evaluated data from the REGARDS study on 24,117 participants (mean age, 65 years; 55% women; 38% black). AF was identified using baseline ECG data and self-reported history. Participants who reported at least two falls within 12 months of a baseline exam were classified as having a positive fall history.
Wesley T. O'Neal
In total, 8.3% of participants had AF at baseline and 6.7% reported a history of falls. More falls were reported among those with AF than those without AF (10% vs. 6.5%; P < .0001), the researchers wrote. AF was significantly associated with falls after adjustment for demographics and risk factors for falling (OR = 1.21; 95% CI, 1.03-1.43), but this association was not observed when stratified by age, sex, race, cognitive impairment, mobility impairment or benzodiazepine use, O’Neal and colleagues wrote.
Compared with participants with neither AF nor a history of falls, those with either AF (HR = 1.44; 95% CI< 1.28-1.62) or a history of falls (HR = 1.61; 95% CI, 1.42-1.82) were associated with increased risk for mortality. However, the risk increase was greatest among patients with both AF and a history of falls (HR = 2.12; 95% CI, 1.64-2.74), the researchers wrote.
“It is unclear why persons with AF are more likely to fall,” O’Neal told Cardiology Today. He noted, however, that AF is associated with several conditions that also are associated with falls, such as advanced age, diabetes, depression and cognitive decline. Therefore, “it is plausible that the association between both conditions is explained by these common factors.” Alternative explanations may include use of specific medications and associated symptoms, he said.
“Although several of the above explanations link AF with falls, we were unable to determine the underlying mechanism, and further research is needed to better understand our findings,” O’Neal said. “Overall, our study suggests that those with AF will benefit from interventions to reduce falls and this also may improve the survival of persons who have the arrhythmia.” – by Trish Shea, MA
Disclosure: The researchers report no relevant financial disclosures.
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