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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Frontiers Media S.A.
2025-07-01
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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. |
| format | Article |
| id | doaj-art-90c6578d11a846fa8eb0e0e214d4e33d |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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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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