| J Hum Hypertens 18:301-305, 2004 |
|
| Orthostatic hypotension in the elderly: are the diagnostic criteria
adequate? |
|
| Weiss A, Chagnac A, Beloosesky Y, Weinstein T, Grinblat J, Grossman
E |
|
| Geriatric Department, Rabin Medical Center, Golda Campus and Internal
Medicine D and Hypertension unit Tel Hashomer |
|
| Orthostatic hypotension (OH) is a common finding in the elderly.
OH is 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.
Some patients exhibit a fall in BP of less than the defined OH upon
standing. The aim of this study was to estimate the prevalence of BP
changes not defined as OH among elderly in-patients and to assess the
relationship between these changes in the morning and the occurrence
of OH during the day. Postural BP measurements were performed in 502
in-patients; in the morning, early afternoon, and in the evening. We
defined intermediate postural drop (ID) in BP as a decrease of 10-19
mmHg in systolic BP and/or of 5-9 mmHg in diastolic BP. We observed
that OH and ID occurred in 39.2 and 18.5% of the measurements in the
morning, respectively. The prevalence of OH and ID was lower in the
evening than in the morning (P<0.05) and afternoon (P<0.005).
Postural BP changes in the morning correlated with those occurring
later in the day. Patients who had ID in the morning had a 57% probability
of having OH later during the day. In conclusions, ID is prevalent
in elderly in-patients. ID in the morning predicts OH later in the
day. Thus, postural BP drops below the OH range may be an important
finding in the geriatric population. |
