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Effect of anticholinergic burden on cardiac functions in older patients

Hakan Fotbolcu1, Pınar Soysal2

  • 1Department of Cardiology, Bezmialem Vakif University, Başıbüyük Mahallesi, Emek Caddesi, Narcity, No: 281 A2b Blok D: 56, Maltepe, Istanbul, Turkey. hakan_fotbolcu@yahoo.com.

Zeitschrift Fur Gerontologie Und Geriatrie
|July 1, 2026
PubMed

Insights

A high anticholinergic burden in older adults is linked to impaired heart function, specifically affecting systolic and diastolic capabilities. However, this burden alone does not fully account for increased hospitalizations and mortality in this population.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Anticholinergic medications are widely prescribed for older adults.
  • A high anticholinergic burden (ACB) is associated with adverse health outcomes.
  • The impact of ACB on cardiac function in the elderly requires further investigation.

Purpose of the Study:

  • To investigate the effects of a high anticholinergic burden on myocardial systolic and diastolic functions.
  • To assess the impact of ACB on cardiac electrical functions in older adults.

Main Methods:

  • Compared 24 patients with high ACB (ACB scale ≥ 2) to 26 controls (ACB=0).
  • Evaluated biventricular systolic and diastolic functions using echocardiography.
  • Measured heart rate and corrected QT interval (cQT) to assess electrophysiological changes.

Main Results:

  • Patients with high ACB showed impaired biventricular systolic and diastolic functions.
  • Key systolic parameters (lateral-S, septal-S, tricuspid-S) were significantly lower in the high ACB group.
  • Left ventricular filling pressure (E/E') was elevated in patients with high ACB.
  • No significant differences in heart rate or cQT were observed between groups.
  • Serum albumin levels were lower in the high ACB group.

Conclusions:

  • A high anticholinergic burden is associated with moderate impairment of systolic and diastolic cardiac functions in older adults.
  • The observed cardiac dysfunction, while significant, does not solely explain the increased hospitalization and mortality rates in this population.
Abstract

Keywords:
Anti-cholinergic burdenCatabolismDiastolic functionsHeart rateSystolic functions

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