High prevalence of orthostatic hypotension and its correlation with potentially causative medications among elderly veterans

Poon, Ivy; Braun, Ursula K.

doi:10.1111/j.1365-2710.2005.00629.x

Cited by 226 publications

(138 citation statements)

References 24 publications

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“…However, the evidence on the relative contribution of each class of medication to the development of OH remains controversial and inconclusive as mentioned previously. 4,8,14,16,18,23,24 Our study did not find any association between medication use and the presence of OH, further suggesting that the differences in hemodynamic responses between the OHN and OHP groups were more likely to be intrinsic and not attributable to any individual medications or clinical conditions.…”

Section: Discussionmentioning

confidence: 56%

“…Previous studies have found similar results that suggested that only 30% to 40% of patients with OH would manifest typical symptoms while the others remained asymptomatic or had atypical symptoms. [2][3][4] This makes the diagnosis of OH difficult, and thus routine measurements are required to vigilantly detect cases.…”

Section: Discussionmentioning

confidence: 99%

“…Although OH is prevalent in the acute medical and geriatric settings, 4,15 we expected it to be equally common in the acute surgical and trauma settings because of the additional risk factors of hypovolemia and immobility postsurgery. 16 Our study demonstrated that the prevalence of OH was at least as common in the surgical and trauma wards as in the medical wards.…”

Section: Discussionmentioning

confidence: 99%

“…1 It is a physical sign and is not always associated with symptoms. [2][3][4] The reported prevalence of OH ranges from 6% in healthy elderly community dwellers to 68% in hospitalized geriatric patients. 5 The prevalence of OH across emergency department presentations is about 3% to 25%.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence, Associations and Risk Factors for Orthostatic Hypotension in Medical, Surgical and Trauma Inpatients: An Observational Cohort Study

Aung

Corcoran

Nagalingam

et al. 2011

Heart, Lung and Circulation

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Background: Orthostatic hypotension (OH) is prevalent in hospitalized elderly patients. It is defined as a reduction in systolic blood pressure (SBP) of at least 20 mmHg and/or diastolic blood pressure (DBP) of at least 10 mmHg within 3 minutes of standing from a lying position. This observational cohort study describes the prevalence, association with symptoms, and risk factors for OH in medical, surgical, and trauma wards in a tertiary hospital and the differences in hemodynamic behaviors between OH-positive (OHP) and OH-negative (OHN) patients. Methods: All 76 patients who were hemodynamically stable and able to stand from 4 hospital wards had noninvasive supine and orthostatic blood pressures (BPs) and pulse rates (PRs) measured over 4 days. Results: Mean age of the 76 patients included in the study was 67.8 6 19.6 years. Overall prevalence of OH was 23.7% (95% CI: 14.7%-34.8%) with 21.2% (95% CI: 9.0%-38.9%) in medical, 31.8% (95% CI: 13.9%-54.9%) in surgical, and 19.0% (95% CI: 5.4%-41.9%) in trauma wards. OH had no association with symptoms (P 5 .53). We found no differences in age, number of comorbidities, and medication use between the OHN and OHP groups.The two groups displayed very different hemodynamic responses. The OHN group demonstrated a statistically significant compensatory rise in BP and PR over time to orthostatic

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence, Associations and Risk Factors for Orthostatic Hypotension in Medical, Surgical and Trauma Inpatients: An Observational Cohort Study

Aung

Corcoran

Nagalingam

et al. 2011

Heart, Lung and Circulation

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“…50 Causes of OH in hypertensive patients include use of some anti-hypertensive drugs, mainly including diuretics, ACE inhibitors, CCBs, and alpha blockers. 51 Symptoms preceding an OH incident include visual disorders, vertigo, dysarthria, and falling after verticalisation. In addition to anti- …”

Section: Care For Frail Patientsmentioning

confidence: 99%

Hypertension and Frailty Syndrome in Old Age: Current Perspectives

Uchmanowicz

Chudiak

Jankowska‐Polańska

et al. 2017

Cardiac Failure Review

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Hypertension is considered the most common disorder in the general population. It is both a health and a financial problem worldwide.The Writing Group of the American Society of Hypertension defines hypertension as a cardiovascular syndrome resulting from a number of interconnected factors. 1 Therefore, a comprehensive evaluation is required, involving both the cardiovascular system and other risk factors. In the global population, the prevalence of hypertension is 26.4 %, which is expected to increase to one-third of the population by 2025. 2 The elderly comprise a special group of hypertensive patients because of ageing-related processes. In accordance with data from the Framingham study, 58.9 % of people aged ≥65 and 70 % of those aged ≥80 years are hypertensive. 3 Most patients in the group have isolated systolic hypertension, with normal diastolic blood pressure (DBP) valuesbelow 90 mmHg. In the elderly population, systolic blood pressure (SBP) is a more significant risk factor for cardiovascular complications than DBP. Chronic high SBP leads to left ventricular hypertrophy, as decreased elasticity of large blood vessels -particularly the aortaputs extra strain on the heart. 4 The ageing process involves a number of changes contributing to the development of hypertension. Besides decreased blood vessel elasticity, these include increased collagen content in the extracellular matrix, decreased numbers of elastic fibres, increased vessel wall thickness, and decreased vessel lumen.In the elderly, the lower number of elastic fibres in the vessel wall contributes to increased SBP. AbstractHypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease. Considering the physiological changes resulting from ageing alongside multiple comorbidities, treatment of hypertension in elderly patients poses a significant challenge to treatment teams. Progressive disability with regard to the activities of daily life, more frequent hospitalisations and low quality of life are often seen in elderly patients. There is discussion in the literature regarding frailty syndrome associated with old age. Frailty is understood to involve decreased resistance to stressors, depleted adaptive and physiological reserves of a number of organs, endocrine dysregulation and immune dysfunction. The primary dilemma concerning frailty is whether it should only be defined on the basis of physical factors, or whether psychological and social factors should also be included. Proper nutrition and motor rehabilitation should be prioritised in care for frail pa...

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