Prevalence of postural hypotension in elderly patients in a long-term health care facility

Aronow, Wilbert S.; Lee, Neung H.; Sales, Francie F.; Etienne, Fritzner

doi:10.1016/0002-9149(88)90243-3

Cited by 51 publications

(28 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, it was common and appeared in 49.1% of our patients. In a handful of other studies, the rate of postural hypotension on transition from a lying to a sitting position was 54% in older patients hospitalized for various acute conditions [14] , 15.2% in older patients following blood donation [13] , 8% in elderly patients in a long-term health care facility [11] , and 6.6% in a community-dwelling population [12] .…”

Section: Discussionmentioning

confidence: 99%

“…However, no information exists concerning development of postural hypotension in this clinical context and the eventual effectiveness of preventive measures. Seating-induced postural hypotension was investigated in only a handful of studies [11][12][13][14][15] , two of which were of older inpatients [14,15] . In one of the studies, postural hypotension appeared in 54% of patients and relevant symptoms in 80.6% [14] .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Seating-Induced Postural Hypotension Is Common in Older Patients with Decompensated Heart Failure and May Be Prevented by Lower Limb Compression Bandaging

et al. 2008

View full text Add to dashboard Cite

Background: Postural hypotension induced by transition from supine to sitting position and measures for its prevention in heart failure has not been investigated. Objective: Our purpose was to evaluate the prevalence of postural hypotension and associated clinical manifestations as well as the contribution of various risk factors for postural hypotension on transition from lying to sitting in older patients with decompensated heart failure, and to study the eventual preventive effect of leg bandaging. Methods: Seating-induced postural hypotension (≥20 mm Hg systolic and/or ≥10 mm Hg diastolic blood pressure fall) was assessed on the first study day in 108 patients aged ≥60 years, hospitalized for acutely decompensated heart failure. On the next day, in patients manifesting postural hypotension, compression bandages were applied along both legs before seating. Blood pressure, heart rate, O₂ saturation, and the occurrence of dizziness or palpitations were recorded prior to and 1, 3 and 5 min following seating. Results: Postural hypotension occurred in 49.1% of patients. Dizziness and/or palpitations manifested in 25%. Diastolic (36.1%) versus systolic (23.1%) postural hypotension prevailed (p = 0.05). On univariate analysis, postural hypotension was associated with female sex (p = 0.03), more severe heart failure (p = 0.05), longer bedrest (p = 0.04), higher supine systolic (p = 0.01) or diastolic (p = 0.002) blood pressure, nonischemic heart failure (p = 0.002), and not using nitrates (p = 0.01). On multivariate analysis, longer bedrest (OR = 1.58, 95% CI = 1.13–2.2, p < 0.001), higher supine diastolic blood pressure (OR = 1.33, 95% CI = 1.1–1.61, p = 0.001), and nonischemic heart failure (OR = 3.48, 95% CI = 1.4–8.63, p = 0.009) were the most predictive of postural hypotension. Compression bandages prevented postural hypotension in 21 of 49 patients and decreased the degree of postural blood pressure fall (p < 0.001). Conclusion: Seating-induced postural hypotension is common among older inpatients with decompensated heart failure, especially with longer bedrest, higher supine diastolic blood pressure and non-ischemic etiology. Leg compression bandaging may be useful for the prevention of postural hypotension in these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Seating-Induced Postural Hypotension Is Common in Older Patients with Decompensated Heart Failure and May Be Prevented by Lower Limb Compression Bandaging

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Age and abnormalities in blood pressure homeostasis may predispose to orthostatic hypotension, a very common condition among older persons [1][2][3]. Orthostatic hypotension is associated with syncope [4], falls [5] and stroke [6], and hence represents an important cause of hospitalization and functional impairment.…”

Section: Introductionmentioning

confidence: 99%

Arterial stiffness as the candidate underlying mechanism for postural blood pressure changes and orthostatic hypotension in older adults: the Rotterdam Study

Mattace-Raso¹,

Cammen²,

Knetsch³

et al. 2006

Journal of Hypertension

119

View full text Add to dashboard Cite

show abstract

“…Surprisingly, similar published information concerning transition from a lying to sitting position is scarce [1, 2, 3, 4]. It appears, however, that the resulting hemodynamic consequences and symptomatic manifestations are similar in both situations.…”

Section: Discussionmentioning

confidence: 99%

“…Data in the literature concerning postural hypotension (PH) generated by transition from supine to sitting position are surprisingly scarce [1, 2, 3, 4]. Moreover, measures for its prevention have not been investigated.…”

Section: Introductionmentioning

confidence: 99%

Lower Limb Compression Bandaging Is Effective in Preventing Signs and Symptoms of Seating-Induced Postural Hypotension

Gorelik¹,

Fishlev²,

Almoznino‐Sarafian³

et al. 2004

Cardiology

View full text Add to dashboard Cite

Background and Aims: Data concerning postural hypotension (PH) induced by transition from supine to sitting position are scarce and measures for its prevention have not been investigated. Our objective was to assess the preventive role of lower limb compression bandaging on PH and associated manifestations in older inpatients when seated from lying position. Methods: In a randomized crossover study, 61 patients aged >65 years were enrolled. Following bed rest lasting >36 h, each patient was seated and studied for 2 consecutive days, unbandaged or bandaged. PH was defined as a fall of ≧20 mm Hg and/or ≧10 mm Hg in systolic/diastolic blood pressure, respectively. Compression bandages were applied along both legs before seating; the pressure was approximately 30 mm Hg. Blood pressure, heart rate, O₂ saturation, dizziness and palpitations were recorded prior to and 1, 3, and 5 min following seating. Results: Prevalence of PH was identical in the unbandaged versus bandaged state (55.7%). However, dizziness, palpitations, accelerated heart rate and decreased O₂ saturation over 5 min were more prevalent in the unbandaged versus bandaged state (p < 0.01, <0.001, <0.05, <0.001, respectively). In the unbandaged state, presence versus absence of PH was associated with significantly greater incidence of palpitations, tachycardia and decline of O₂ saturation over time (p < 0.04, <0.03, <0.03, respectively). In the bandaged state, O₂ saturation over 5 min tended to rise irrespective of PH, but mean values were higher in patients without PH (p < 0.02). Conclusions: Lower limb compression bandaging does not reduce the incidence of PH. However, associated manifestations are largely prevented.

show abstract

Prevalence of postural hypotension in elderly patients in a long-term health care facility

Cited by 51 publications

References 6 publications

Seating-Induced Postural Hypotension Is Common in Older Patients with Decompensated Heart Failure and May Be Prevented by Lower Limb Compression Bandaging

Seating-Induced Postural Hypotension Is Common in Older Patients with Decompensated Heart Failure and May Be Prevented by Lower Limb Compression Bandaging

Arterial stiffness as the candidate underlying mechanism for postural blood pressure changes and orthostatic hypotension in older adults: the Rotterdam Study

Lower Limb Compression Bandaging Is Effective in Preventing Signs and Symptoms of Seating-Induced Postural Hypotension

Contact Info

Product

Resources

About