Abstract P286: ARTERIAL STIFFNESS IN OLDER FRAGILE PATINETS WITH ORTHOSTATIC HYPOTENSION

Abstract

Aim: To study the relationship between orthostatic hypotension (OH) and arterial stiffness in older fragile adults with arterial hypertension (AH). Material and Methods: The study included 160 patients (77.2 ± 8.1 years) with verified hypertension. The actual intake of previously prescribed drugs was assessed. The patients were divided into three groups: group 1 of patients with frailty, group 2 - with pre-frailty, group 3 of patients without frailty. Arterial stiffness was assessed by volumetric sphygmometry (VaSera-VS-1500 device, FUKUDA DENSHI, Japan) with the determination of the Augmentation index (Aix index). The orthostatic test was considered positive, with a decrease in SBP by 20 and DADA by 10 mm Hg. Art. and more when moving to a vertical position for 1-3 minutes. Results: Orthostatic hypotension was present in 53 patients (33%). Patients with OH did not differ in age from patients without OH (77.9 ± 7.5 years vs. 76.8 ± 8.4 years; p = 0.418). The Aix index is higher in patients with OH, but these differences reach statistical significance only in the group of patients with frailty (11.0 ± 1.2 vs. 10.0 ± 1.6 p = 0.003). When analyzing the antihypertensive drugs taken, there were no significant differences in the total number of drugs within each group and between patients with OH and without OH (p = 0.95). The analysis for individual groups of drugs revealed an inverse relationship between the use of ACE inhibitors and OH in the group as a whole (ϕ = -0.205, p = 0.010), and in the group of patients with frailty, marginal significance (ϕ = -0.266, p = 0.05). Findings: OH is observed in 33% of patients 60 years and older with hypertension. Arterial stiffness increases with increasing “fragility” and concomitant OH in the group of patients 60 years and older. The progression of arterial stiffness in older adults is heterogeneous and depends on concomitant frailty.