TY - JOUR
T1 - Diuretics, SGLT2 inhibitors and falls in older heart failure patients
T2 - to prescribe or to deprescribe? A clinical review
AU - van Poelgeest, Eveline P.
AU - On behalf of the EUGMS Task & Finish group on Fall-risk-increasing drugs
AU - Handoko, M. Louis
AU - Muller, Majon
AU - van der Velde, Nathalie
N1 - Funding Information: This paper was written on behalf of the EuGMS Task & Finish group on FRIDs. The T&F group consists of the following members: Austria: Heinrich Thaler; Belgium: Mirko Petrovic; Czech Republic: Eva Topinková, Denmark: Jesper Ryg; Finland: Sirpa Hartikainen; France: Hubert Blain, Jean Bousquet; Ireland: Irene O’Byrne-Maguire, Rose Anne Kenny; Italy: Francesco Landi; Netherlands: Tischa van der Cammen, Marielle Emmelot-Vonk, Eveline van Poelgeest, Lotta Seppälä, Nathalie van der Velde; Poland: Katarzyna Szczerbińska; Spain: Leocadio Rodriguez Mañas, Marta Gutiérrez-Valencia, Maria Angeles Caballero-Mora; Sweden: Lucie Laflamme, Gösta Bucht, Yngve Gustafsson, Olle Svensson, Patrik Eklund, Ulrika Pettersson-Kymmer; Turkey: Gulistan Bahat, Birkan Ilhat; UK: Tash Masud, Alpana Mair, Tomas Welsh, Yvonne Morrissey. Publisher Copyright: © 2023, The Author(s).
PY - 2023/8
Y1 - 2023/8
N2 - Aim: This study aimed at summarizing the available literature on fall risk associated with diuretic and SGLT2i use in older heart failure patients, including the underlying pathophysiology, and to assist clinicians in safe (de)prescribing of these drug classes. Findings: Both heart failure and diuretic or SGLT2 inhibitor use increase fall risk in older adults. Diuretics and SGLT2 inhibitors not only have various fall-related adverse effects, which partly overlap (e.g. tendency to cause hypotension), but also differ: compared to SGLT2is, diuretics display more fall risk factors (e.g. electrolyte abnormalities). The tendency to cause fall-related adverse effects may differ according to diuretic sub-class or even within sub-classes. Message: Decisions to continue or deprescribe diuretics or SGLT2is in fall-prone older HF patients are generally highly complex, but detailed insight into fall-related side effect profiles of these drug classes, and practical clinical decision tools and resources, assist prescribers in rational and personalized (de)prescribing.
AB - Aim: This study aimed at summarizing the available literature on fall risk associated with diuretic and SGLT2i use in older heart failure patients, including the underlying pathophysiology, and to assist clinicians in safe (de)prescribing of these drug classes. Findings: Both heart failure and diuretic or SGLT2 inhibitor use increase fall risk in older adults. Diuretics and SGLT2 inhibitors not only have various fall-related adverse effects, which partly overlap (e.g. tendency to cause hypotension), but also differ: compared to SGLT2is, diuretics display more fall risk factors (e.g. electrolyte abnormalities). The tendency to cause fall-related adverse effects may differ according to diuretic sub-class or even within sub-classes. Message: Decisions to continue or deprescribe diuretics or SGLT2is in fall-prone older HF patients are generally highly complex, but detailed insight into fall-related side effect profiles of these drug classes, and practical clinical decision tools and resources, assist prescribers in rational and personalized (de)prescribing.
KW - Deprescribing
KW - Diuretics
KW - Falls
KW - Geriatric
KW - Sodium-glucose cotransporter-2 inhibitors
UR - http://www.scopus.com/inward/record.url?scp=85147276961&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s41999-023-00752-7
DO - https://doi.org/10.1007/s41999-023-00752-7
M3 - Review article
C2 - 36732414
SN - 1878-7649
VL - 14
SP - 659
EP - 674
JO - European Geriatric Medicine
JF - European Geriatric Medicine
IS - 4
ER -