Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients – a retrospective cross-sectional study

BackgroundCalcium channel blockers, such as amlodipine, are commonly prescribed for hypertension but can cause peripheral edema, often requiring adjunctive frusemide. Concerns exist regarding the potential increase in fall risk, particularly in older populations. However, few studies have assessed t...

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Main Authors: Aymen Alqurain, Murtada Albaharnah, Samanah Al Zayer, Maha Alanzi, Razan Alblushi, Rawan Aleid, Rand Ashoor, Ali Albahrani, Mustafa Almahdi, Samaher Al-Shaibi, Luma Ameer, Sherihan Ghosn, Marwa Algoraini, Nawal Alsubaie, Afnan Alshnbari, Fadhel A. Alomar
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1598161/full
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author Aymen Alqurain
Murtada Albaharnah
Samanah Al Zayer
Maha Alanzi
Maha Alanzi
Razan Alblushi
Razan Alblushi
Rawan Aleid
Rand Ashoor
Ali Albahrani
Mustafa Almahdi
Samaher Al-Shaibi
Luma Ameer
Sherihan Ghosn
Marwa Algoraini
Nawal Alsubaie
Afnan Alshnbari
Fadhel A. Alomar
author_facet Aymen Alqurain
Murtada Albaharnah
Samanah Al Zayer
Maha Alanzi
Maha Alanzi
Razan Alblushi
Razan Alblushi
Rawan Aleid
Rand Ashoor
Ali Albahrani
Mustafa Almahdi
Samaher Al-Shaibi
Luma Ameer
Sherihan Ghosn
Marwa Algoraini
Nawal Alsubaie
Afnan Alshnbari
Fadhel A. Alomar
author_sort Aymen Alqurain
collection DOAJ
description BackgroundCalcium channel blockers, such as amlodipine, are commonly prescribed for hypertension but can cause peripheral edema, often requiring adjunctive frusemide. Concerns exist regarding the potential increase in fall risk, particularly in older populations. However, few studies have assessed the prevalence of amlodipine and frusemide combination (AFC) prescriptions and their association with fall risk factors.ObjectivesThe aims of this study are to determine the prevalence of AFC prescriptions and evaluate their association with fall risk factors in an outpatient cardiology clinic population.MethodsThis retrospective, cross-sectional study included patients aged ≥40 years from Al-Qatif Central Hospital’s outpatient cardiology clinic (January 2021 -December 2022) prescribed amlodipine. Fall risk factors were identified from literature. The Charlson Comorbidity Index (CCI) was used to estimate 1-year mortality risk. The number of prescribed orthostatic hypotension-inducing drugs (OHDs) and fall-risk increasing drugs (FRIDs) was recorded. Binary logistic regression was performed to determine the association between AFC prescriptions and fall risk factors, adjusting for significant covariates. Results are expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).ResultsOf 3,681 patients, 18%. Were prescribed AFC. AFC patients were older (70 vs. 64 years, P < 0.001), had a higher prevalence of diabetes mellitus (64% vs. 44%, P < 0.001), anemia (55% vs. 32%, P < 0.001), and osteoporosis (51% vs. 28%, P < 0.001), and received more OHDs prescriptions (2.8 vs. 1.3, P < 0.001) compared to non-AFC patients. Higher CCI scores (OR = 1.51, 95% CI 1.41–1.62) and more OHDs prescriptions (OR = 2.5, 95% CI 2.3–2.7) were significantly associated with AFC prescriptions.ConclusionAFC prescriptions are prevalent, and patients prescribed AFC have higher prevalence of fall risk factors. Comprehensive patients assessment is essential to minimize fall risk and related complications.
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series Frontiers in Pharmacology
spelling doaj-art-90c6578d11a846fa8eb0e0e214d4e33d2025-08-20T03:34:30ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-07-011610.3389/fphar.2025.15981611598161Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients – a retrospective cross-sectional studyAymen Alqurain0Murtada Albaharnah1Samanah Al Zayer2Maha Alanzi3Maha Alanzi4Razan Alblushi5Razan Alblushi6Rawan Aleid7Rand Ashoor8Ali Albahrani9Mustafa Almahdi10Samaher Al-Shaibi11Luma Ameer12Sherihan Ghosn13Marwa Algoraini14Nawal Alsubaie15Afnan Alshnbari16Fadhel A. Alomar17Department of Clinical Practice, Faculty of Pharmacy, Northern Border University, Rafha, Saudi ArabiaDepartment of Pharmaceutical Care, King Fahad University Hospital, Imam Abdulrahman bin Faisal University, Al Khobar, Saudi ArabiaDepartment of Pharmaceutical Care, Mouwasat Hospital, Qatif, Saudi ArabiaDepartment of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi ArabiaDepartment of Pharmaceutical Care, RAM Clinics, Al Khobar, Saudi ArabiaDepartment of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi ArabiaDepartment of Pharmaceutical Care, Mouwasat Hospital, Al Khobar, Saudi ArabiaDepartment of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi ArabiaSchool of Medicine, Dar Al Uloom University, Riyadh, Saudi ArabiaDepartment of Respiratory Therapy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi ArabiaDepartment of Respiratory Therapy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi ArabiaPharmacy Services Department, Johns Hopkins Aramco Healthcare (JHAH), Dhahran, Saudi ArabiaDepartment of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi ArabiaDepartment of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia0Foundation Year Department, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia1Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaDepartment of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia2Department of Pharmacology, College of Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaBackgroundCalcium channel blockers, such as amlodipine, are commonly prescribed for hypertension but can cause peripheral edema, often requiring adjunctive frusemide. Concerns exist regarding the potential increase in fall risk, particularly in older populations. However, few studies have assessed the prevalence of amlodipine and frusemide combination (AFC) prescriptions and their association with fall risk factors.ObjectivesThe aims of this study are to determine the prevalence of AFC prescriptions and evaluate their association with fall risk factors in an outpatient cardiology clinic population.MethodsThis retrospective, cross-sectional study included patients aged ≥40 years from Al-Qatif Central Hospital’s outpatient cardiology clinic (January 2021 -December 2022) prescribed amlodipine. Fall risk factors were identified from literature. The Charlson Comorbidity Index (CCI) was used to estimate 1-year mortality risk. The number of prescribed orthostatic hypotension-inducing drugs (OHDs) and fall-risk increasing drugs (FRIDs) was recorded. Binary logistic regression was performed to determine the association between AFC prescriptions and fall risk factors, adjusting for significant covariates. Results are expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).ResultsOf 3,681 patients, 18%. Were prescribed AFC. AFC patients were older (70 vs. 64 years, P < 0.001), had a higher prevalence of diabetes mellitus (64% vs. 44%, P < 0.001), anemia (55% vs. 32%, P < 0.001), and osteoporosis (51% vs. 28%, P < 0.001), and received more OHDs prescriptions (2.8 vs. 1.3, P < 0.001) compared to non-AFC patients. Higher CCI scores (OR = 1.51, 95% CI 1.41–1.62) and more OHDs prescriptions (OR = 2.5, 95% CI 2.3–2.7) were significantly associated with AFC prescriptions.ConclusionAFC prescriptions are prevalent, and patients prescribed AFC have higher prevalence of fall risk factors. Comprehensive patients assessment is essential to minimize fall risk and related complications.https://www.frontiersin.org/articles/10.3389/fphar.2025.1598161/fullamlodipinefrusemideprescribing cascadefall riskorthostatic hypotension
spellingShingle Aymen Alqurain
Murtada Albaharnah
Samanah Al Zayer
Maha Alanzi
Maha Alanzi
Razan Alblushi
Razan Alblushi
Rawan Aleid
Rand Ashoor
Ali Albahrani
Mustafa Almahdi
Samaher Al-Shaibi
Luma Ameer
Sherihan Ghosn
Marwa Algoraini
Nawal Alsubaie
Afnan Alshnbari
Fadhel A. Alomar
Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients – a retrospective cross-sectional study
Frontiers in Pharmacology
amlodipine
frusemide
prescribing cascade
fall risk
orthostatic hypotension
title Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients – a retrospective cross-sectional study
title_full Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients – a retrospective cross-sectional study
title_fullStr Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients – a retrospective cross-sectional study
title_full_unstemmed Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients – a retrospective cross-sectional study
title_short Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients – a retrospective cross-sectional study
title_sort amlodipine and frusemide pharmacological factors contributing to increased fall risk in concurrently treated patients a retrospective cross sectional study
topic amlodipine
frusemide
prescribing cascade
fall risk
orthostatic hypotension
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1598161/full
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