Falls are a leading cause of injury in older adults and carry the risk of permanent disability, high medical costs, and premature death. For people with cardiovascular disease, the risk of falling is even higher, with 60 percent at moderate or high risk for falls. Medications, increased frailty, abnormal heart rhythms, low blood pressure, and fainting are some of the reasons for a fall. 

Even when falls don’t cause significant injury, they can result in increased fear of falling and functional decline in seniors, leading to a diminished quality of life. But despite the frequency of falls among people with cardiovascular disease, the topic is often overshadowed by other medical issues. Many older adults may also be hesitant to mention falls to healthcare professionals or others in their life, thinking they will lose independence in their day-to-day activities and be treated differently. 

Certain medications for cardiovascular conditions, such as high blood pressure, can contribute to falls. The same is true for prescription drugs for non-heart-related conditions. Medications that can increase increase risk of falls include:

• Arrhythmia medications.
• Antidepressants.
• Antipsychotics.
• Anti-anxiety medications (benzodiazepines) such as lorazepam and nonbenzodiazepine, and sedative hypnotics such as zolpidem.
• Diabetes medications and diuretics.
• High blood pressure medicine, including beta-blockers, ACE inhibitors, and angiotensin receptor blockers (ARBs).
• Opioids.
• Non-steroidal anti-inflammatory drugs.
• Selective serotonin reuptake inhibitors.

It’s important to discuss the side-effects of all medications with a healthcare professional and weigh any increased risks of falling. It’s often possible to choose medications with fewer side-effects or that can be taken in lower doses. In some cases, alternative, non-pharmacological options may be available and should also be discussed with your doctor or pharmacist. 

Here’s a rundown of cardiovascular conditions that can lead to falling:

Fainting (syncope).

A person with decreased blood flow to the brain can lose consciousness and fall. The risk increases with age. In addition, people with cardiovascular conditions are more likely to suffer from low blood pressure and experience dizziness and faint.
Heart failure and arrhythmia.

A person’s heart may not pump as efficiently or may beat in an irregular rhythm, causing a decrease in blood flow to the brain. They are also more likely to take multiple prescriptions, which may increase dizziness. People with heart failure are more likely to fall than those with other chronic diseases.and suffer a fracture that requires hospitalization. 
Atrial fibrillation.

Patients with this irregular, rapid heartbeat also face a higher fall risk.
Other non-cardiovascular conditions–arthritis, neurological problems, deafness, blindness, and cognitive impairment such as dementia–can affect mobility and balance, and in turn increase the likelihood of falling. The risk can be reduced by:

• Addressing hazards at home such as loose rugs, mats, clutter and stairs, and ensuing adequate lighting and ambient temperature.
• Wearing comfortable footwear.
• Incorporating physical and occupational therapy into wellness plans.
• Review medications.

Source: American Heart Association.