in individuals with heart failure approaching the end of
life, and there is limited knowledge on the best way to
manage these individuals [49]. The elevated risk of falling
in the elderly with heart failure may be explained by
its pharmacotherapy (e.g. diuretics, ACE inhibitors, betablockers)
and their association with falls, although these
categories of pharmaceuticals did not individually
predict falls in our study. Response to pharmacotherapy
for heart failure varies in elderly individuals, who
are susceptible to adverse events such as orthostatic
hypotension, dehydration, electrolyte disturbance, incontinence
and drug-drug interactions [47]. One common
side effect of diuretics is hyponatraemia, which is associated
with impairment of gait and attention. Stable mild
chronic hyponatraemia is generally considered asymptomatic,
although Renneboog (2006) observed a high number
of falls in comparison to controls in hyponatraemic subjects
considered clinically asymptomatic. Furthermore,
individuals with moderate chronic hyponatraemia fell dramatically
more frequently than patients with normal
serum sodium levels [50].
in individuals with heart failure approaching the end oflife, and there is limited knowledge on the best way tomanage these individuals [49]. The elevated risk of fallingin the elderly with heart failure may be explained byits pharmacotherapy (e.g. diuretics, ACE inhibitors, betablockers)and their association with falls, although thesecategories of pharmaceuticals did not individuallypredict falls in our study. Response to pharmacotherapyfor heart failure varies in elderly individuals, whoare susceptible to adverse events such as orthostatichypotension, dehydration, electrolyte disturbance, incontinenceand drug-drug interactions [47]. One commonside effect of diuretics is hyponatraemia, which is associatedwith impairment of gait and attention. Stable mildchronic hyponatraemia is generally considered asymptomatic,although Renneboog (2006) observed a high numberof falls in comparison to controls in hyponatraemic subjectsconsidered clinically asymptomatic. Furthermore,individuals with moderate chronic hyponatraemia fell dramaticallymore frequently than patients with normalserum sodium levels [50].
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