Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Sep;247(9):1235-41.
doi: 10.1007/s00417-009-1092-8. Epub 2009 May 19.

Evaluation of risk of falls and orthostatic hypotension in older, long-term topical beta-blocker users

Wishal D Ramdas  1 , Nathalie van der Velde, Tischa J M van der Cammen, Roger C W Wolfs
Affiliations

Evaluation of risk of falls and orthostatic hypotension in older, long-term topical beta-blocker users

Wishal D Ramdas et al. Graefes Arch Clin Exp Ophthalmol. 2009 Sep.

Abstract

Background: Falls are a serious problem in the elderly, and have recently been described as cardiovascular-mediated side effects of beta-blocker eye drops. Therefore, we investigated the possible association between the long-term use of beta-blockers, prostaglandins and their combinations in eye drops, and falls, dizziness and orthostatic hypotension in older patients.

Methods: All participants were long-term users of eye drops containing beta-blockers, prostaglandins or their combinations. They underwent a structured falls interview and blood pressure measurement for testing of orthostatic hypotension. The odds ratio for presence of orthostatic hypotension or a positive falls history according to use of beta-blocker eye drops was calculated with a binary logistic regression analysis. The main outcome measures were a positive falls history and the presence of orthostatic hypotension.

Results: In total, 148 of 286 subjects participated. After adjustment for age, gender, and use of fall-risk-increasing drugs other than beta-blocker eye drops, we found no significant difference in fall risk [odds ratio (OR): 0.60; 95% confidence interval (CI): 0.268-1.327] between patients using ophthalmic beta-blockers or a combination of ophthalmic beta-blockers and prostaglandins, and patients using ophthalmic prostaglandins only. Although prevalence of orthostatic hypotension was higher in the beta-blocker group (OR: 1.67; 95% CI: 0.731-3.793) compared to the prostaglandin group, this was a non-significant difference.

Conclusions: In our study, we did not find a significant association between long-term use of beta-blockers eye drops and falls, dizziness or orthostatic hypotension in older ophthalmic outpatients, compared to long-term use of prostaglandin eye drops.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Eye drops used, and their groups, with total frequencies of population. (Types of eye drop for lowering intraocular pressure)
Fig. 2
Fig. 2
Mean pulse rates. (u.p. = upright position)
See this image and copyright information in PMC

Comment in

  • A myth of ophthalmic beta-blockers therapy.
    Kittisupamongkol W. Kittisupamongkol W. Graefes Arch Clin Exp Ophthalmol. 2009 Dec;247(12):1721; author reply 1723. doi: 10.1007/s00417-009-1164-9. Epub 2009 Aug 20. Graefes Arch Clin Exp Ophthalmol. 2009. PMID: 19693528 Free PMC article. No abstract available.

Similar articles

See all similar articles

Cited by

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1136/bmj.38506.594977.E0', 'is_inner': False, 'url': 'https://doi.org/10.1136/bmj.38506.594977.e0'}, {'type': 'PMC', 'value': 'PMC558697', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC558697/'}, {'type': 'PubMed', 'value': '15994659', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15994659/'}]}
    2. Maier PC, Funk J, Schwarzer G, Antes G, Falck-Ytter YT (2005) Treatment of ocular hypertension and open angle glaucoma: meta-analysis of randomised controlled trials. BMJ 331:134 - PMC - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '12365904', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12365904/'}]}
    2. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M (2002) Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol 120:1268–1279 - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1093/ageing/26.2.63', 'is_inner': False, 'url': 'https://doi.org/10.1093/ageing/26.2.63'}, {'type': 'PubMed', 'value': '9177660', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/9177660/'}]}
    2. Diggory P, Franks WA (1997) Glaucoma therapy may take your breath away. Age Ageing 26:63–67. doi:10.1093/ageing/26.2.63 - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '3882377', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/3882377/'}]}
    2. Munroe WP, Rindone JP, Kershner RM (1985) Systemic side effects associated with the ophthalmic administration of timolol. Drug Intel Clin Pharm 19:85–89 - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1046/j.1532-5415.2002.50226.x', 'is_inner': False, 'url': 'https://doi.org/10.1046/j.1532-5415.2002.50226.x'}, {'type': 'PubMed', 'value': '12028187', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12028187/'}]}
    2. Novack GD, O'Donnell MJ, Molloy DW (2002) New glaucoma medications in the geriatric population: efficacy and safety. J Am Geriatr Soc 50:956–962. doi:10.1046/j.1532-5415.2002.50226.x - PubMed

MeSH terms

Substances