| J Gen Intern Med. 2006 Jun;21(6):602-6. |
|
| Influence of orthostatic hypotension on mortality among patients
discharged from an acute geriatric ward. |
|
| Weiss A, Beloosesky Y, Kornowski R, Yalov A, Grinblat J, Grossman
E. |
|
| Geriatric Department, Rabin Medical Center, and Internal Medicine
D and Hypertension unit Tel Hashomer |
|
| BACKGROUND: Orthostatic hypotension (OH) is a common finding among
older patients. The impact of OH on mortality is unknown. OBJECTIVE:
To study the long-term effect of OH on total and cardiovascular mortality.
PATIENTS AND METHODS: A total of 471 inpatients (227 males and 244
females), with a mean age of 81.5 years who were hospitalized in an
acute geriatric ward between the years 1999 and 2000 were included
in the study. Orthostatic tests were performed 3 times during the day
on all patients near the time of discharge. Orthostatic hypotension
was defined as a fall of at least 20 mmHg in systolic blood pressure
(BP) and/or 10 mmHg in diastolic BP upon assuming an upright posture
at least twice during the day. Patients were followed until August
31, 2004. Mortality data were taken from death certificates. RESULTS:
One hundred and sixty-one patients (34.2%) experienced OH at least
twice. Orthostatic hypotension had no effect on all cause and cause
specific mortality. Over a follow-up of 3.47+/-1.87 years 249 patients
(52.8%) had died 83 of whom (33.3%) had OH. Age-adjusted mortality
rates in those with and without OH were 13.4 and 15.7 per 100 person-years,
respectively. Cox proportional hazards model analysis demonstrated
that male gender, age, diabetes mellitus, and congestive heart failure
increased and high body mass index decreased total mortality. CONCLUSIONS:
Orthostatic hypotension is relatively common in elderly patients discharged
from acute geriatric wards, but has no impact on vascular and nonvascular
mortality. |
