Orthostatic Hypotension at Different Times After Standing Erect in Elderly Adults

Campos, Ana Carolina R.; Almeida, Nathalia Aparecida de; Ramos, André Luiz C.; Vasconcelos, Daniel Fernando Pereira; Freitas, Marco Polo Dias; Toledo, Maria Alice de Vilhena

doi:10.1111/jgs.13324

Cited by 11 publications

(2 citation statements)

References 10 publications

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“…However, assessment of orthostatic hypotension is timeconsuming and difficult in standard medical practice. Furthermore, current recommendations for assessing orthostatic hypotension may be inadequate to diagnose all of those with orthostatic hypotension (Campos et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Low blood pressure levels for fall injuries in older adults: the Health, Aging and Body Composition Study

et al. 2018

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Fall injuries cause morbidity and mortality in older adults. We assessed if low blood pressure (BP) is associated with fall injuries, including sensitivity analyses stratified by antihypertensive medications, in community-dwelling adults from the Health, Aging and Body Composition Study (N = 1819; age 76.6 ± 2.9 years; 53% women; 37% black). Incident fall injuries (N = 570 in 3.8 ± 2.4 years) were the first Medicare claims event from clinic visit (7/00-6/01) to 12/31/08 with an ICD-9 fall code and non-fracture injury code, or fracture code with/without a fall code. Participants without fall injuries (N = 1249) were censored over 6.9 ± 2.1 years. Cox regression models for fall injuries with clinically relevant systolic BP (SBP; ≤ 120, ≤ 130, ≤ 140, > 150 mmHg) and diastolic BP (DBP; ≤ 60, ≤ 70, ≤ 80, > 90 mmHg) were adjusted for demographics, body mass index, lifestyle factors, comorbidity, and number and type of medications. Participants with versus without fall injuries had lower DBP (70.5 ± 11.2 vs. 71.8 ± 10.7 mmHg) and used more medications (3.8 ± 2.9 vs. 3.3 ± 2.7); all P < 0.01. In adjusted Cox regression, fall injury risk was increased for DBP ≤ 60 mmHg (HR = 1.25; 95% CI 1.02-1.53) and borderline for DBP ≤ 70 mmHg (HR = 1.16; 95% CI 0.98-1.37), but was attenuated by adjustment for number of medications (HR = 1.22; 95% CI 0.99-1.49 and HR = 1.12; 95% CI 0.95-1.32, respectively). Stratifying by antihypertensive medication, DBP ≤ 60 mmHg increased fall injury risk only among those without use (HR = 1.39; 95% CI 1.02-1.90). SBP was not associated with fall injury risk. Number of medications or underlying poor health may account for associations of low DBP and fall injuries.

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Section: Introductionmentioning

confidence: 99%

Low blood pressure levels for fall injuries in older adults: the Health, Aging and Body Composition Study

et al. 2018

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“…Other studies 26,27 suggest longer evaluations, of up to 10 minutes, given that many participants develop OH in a delayed manner. In our study, with a lower average age (52.1 ± 9.1 years), some participants also developed more delayed reductions in pressure, given that prevalence was higher at 3 minutes than that at 2, and it was highest at 5.…”

Section: Discussionmentioning

confidence: 99%

A Prevalência da Hipotensão Ortostática e a Distribuição da Variação Pressórica no Estudo Longitudinal da Saúde do Adulto

Velten¹,

Benseñor²,

Lotufo³

et al. 2020

Arquivos Brasileiros De Cardiologia

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Background: Orthostatic hypotension (OH) has been neglected in clinical practice, and there are no studies on its prevalence in the Brazilian population. Objective: To determine the prevalence of OH and blood pressure (BP) changes after the postural change maneuver in participants of the Longitudinal Study of Adult Health. Methods: In this descriptive study of baseline data (N = 14,833 adults, ages 35-74 years), participants remained lying down for 20 minutes and subsequently stood up actively. BP measurements were taken while the participants were supine and at 2, 3, and 5 minutes after standing. OH was defined as a reduction of ≥ 20 mmHg in systolic BP and/or a reduction of ≥ 10 mmHg in diastolic BP at 3 minutes, and its prevalence was determined with a 95% confidence interval (CI). The distribution of BP variation after the postural change maneuver was determined in a subsample (N = 8,011) obtained by removing patients with cardiovascular morbidity and/or diabetes. Results: The prevalence of OH was 2.0% (95% CI: 1.8-2.3), increasing with age. If the criterion applied were a BP reduction during any measurement, the prevalence would increase to 4.3% (95% CI: 4.0-4.7). Symptoms (dizziness, scotoma, nausea, etc.) were reported by 19.7% of participants (95% CI: 15.6-24.6) with OH and 1.4% (95% CI: 1.2-1.6) of participants without OH. The −2 Z-scores of BP variation before and after the postural change maneuver in the subsample were −14.1 mmHg for systolic BP and −5.4 mmHg for diastolic BP. Conclusion: Prevalence of OH varies depending on when BP is measured. Current cutoff points may underestimate the actual occurrence of OH in the population.

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Diagnosis and Differential Diagnosis

Aydın

Mas

2020

Orthostatic Hypotension in Older Adults

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Orthostatic Hypotension at Different Times After Standing Erect in Elderly Adults

Cited by 11 publications

References 10 publications

Low blood pressure levels for fall injuries in older adults: the Health, Aging and Body Composition Study

Low blood pressure levels for fall injuries in older adults: the Health, Aging and Body Composition Study

A Prevalência da Hipotensão Ortostática e a Distribuição da Variação Pressórica no Estudo Longitudinal da Saúde do Adulto

Diagnosis and Differential Diagnosis

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