Citation

Sugitani K, Ito H. Am. J. Med. 2021; 134(8): e474.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.amjmed.2020.08.045

PMID

unavailable

Abstract

We read with great interest the article by Sherer et al entitled "Atrial Fibrillation and the Risk of Subsequent Fracture." This study showed the association between atrial fibrillation and increased risk of incident fracture. The relationship between atrial fibrillation and subsequent fracture has been inconclusive, and this study will add insights into that relationship. However, there is a concern that should be pointed out.

Although this article referred to some potential confounding factors such as decreased brain perfusion, reduced bone density, and heart failure, it did not refer to the effect of polypharmacy. About 70%-80% of patients with atrial fibrillation have other comorbidities such as hypertension and diabetes mellitus.

Due to these multimorbidities, polypharmacy is a major long-time issue facing patients with atrial fibrillation.

Polypharmacy is an established risk factor for falls in the elderly. Medications such as antihypertensive agents and diuretics, in particular, have been regarded as fall risk-increasing drugs. Thus, the effect of polypharmacy cannot be ignored...

Language: en