Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir.
Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
Blood Press Monit. 2020 Oct;25(5):267-270. doi: 10.1097/MBP.0000000000000466.
Orthostatic hypotension is a well-known disorder, but orthostatic hypertension (OHT) still remains unclear in older adults. The aim of this study was to determine the comparison orthostatic hypotension with OHT according to fall risk and geriatric assessment parameters.
A total of 741 patients who were admitted to the geriatric clinic and underwent comprehensive geriatric assessment were reviewed. Orthostatic blood pressure changes were measured by head-up-tilt Table test within the first three minutes. Orthostatic hypotension was defined as 20 or 10-mmHg drop in systolic and/or diastolic blood pressure from supine to standing position. OHT was defined as an increase in systolic blood pressure of 10 mmHg or more while the patient was standing up from the supine position.
The mean age was 75 ± 8 and 65. About 65% of all participants were female. The rate of orthostatic hypotension and OHT was 17.3 and 7.2%, respectively. The falls and dementia were more frequent, and the Instrumental Activities of Daily Living (IADL) score was lower in orthostatic hypotension group than in OHT and control groups (P < 0.05). These variables were similar between OHT and control groups (P > 0.05). The rates of falls [odds ratio (OR) = 2.02; 95% confidence interval (CI), (0.94-4.33); P = 0.044] and dementia [OR = 2.65; 95% CI, (1.08-6.48); P = 0.032] in orthostatic hypotension group were still higher than in OHT group, even after adjusting for age, sex, estimated glomerular filtration rate and drugs.
Orthostatic hypotension may be more significant in terms of falls, dementia and impaired IADLs scores in older adults than in OHT and control groups. It seems that OHT may be of no clinical importance in geriatric practice.
体位性低血压是一种众所周知的疾病，但老年人的体位性高血压（OHT）仍然不清楚。本研究旨在根据跌倒风险和老年评估参数确定与体位性低血压相比 OHT 的比较。
共回顾了 741 名因综合老年评估而入住老年科的患者。在最初的三分钟内，通过头倾斜表测试测量体位性血压变化。体位性低血压定义为仰卧位到站立位时收缩压和/或舒张压下降 20 或 10mmHg。OHT 定义为从仰卧位站立时收缩压升高 10mmHg 或以上。
平均年龄为 75±8 岁，65 岁左右。所有参与者中约有 65%为女性。体位性低血压和 OHT 的发生率分别为 17.3%和 7.2%。体位性低血压组的跌倒和痴呆发生率较高，而日常生活活动（IADL）评分较低，与 OHT 和对照组相比（P<0.05）。OHT 组和对照组之间这些变量相似（P>0.05）。跌倒的发生率[比值比（OR）=2.02；95%置信区间（CI），（0.94-4.33）；P=0.044]和痴呆的发生率[OR=2.65；95%CI，（1.08-6.48）；P=0.032]在体位性低血压组仍然高于 OHT 组，即使在调整年龄、性别、估计肾小球滤过率和药物后也是如此。
与 OHT 和对照组相比，体位性低血压在老年人跌倒、痴呆和受损 IADL 评分方面的意义可能更为显著。在老年实践中，OHT 似乎没有临床意义。
