Abstract
BackgroundOrthostatic hypotension (OH), a blood pressure drop after postural change, is associated with impaired standing balance and falls in older adults. This study aimed to assess the association between blood pressure (BP) and a measure of quality of standing balance, i.e. Center of Pressure (CoP) movement, after postural change from supine to standing position in geriatric outpatients, and to compare CoP movement between patients with and without OH.MethodsIn a random subgroup of 75 consecutive patients who were referred to a geriatric outpatient clinic, intermittent BP measurements were obtained simultaneously with CoP measurements in mediolateral and anterior-posterior direction directly after postural change during 3 min of quiet stance with eyes open on a force plate. Additional measurements of continuous BP were available in n = 38 patients. Associations between BP change during postural change and CoP movement were analyzed using Spearman correlation. Mann-Whitney-U tests were used to compare CoP movement between patients with OH and without OH, in which OH was defined as a BP drop exceeding 20 mmHg of systolic BP (SBP) and/or 10 mmHg of diastolic BP (DBP) within 3 min after postural change.ResultsOH measured intermittently was found in 8 out of 75 (11%) and OH measured continuously in 22 out of 38 patients (57.9%). BP change did not associate with CoP movement. CoP movement did not differ significantly between patients with and without OH.ConclusionsResults do not underpin the added value of CoP movement measurements in diagnosing OH in a clinical setting. Neither could we identify the role of CoP measurements in the understanding of the relation between OH and impaired standing balance.
Highlights
Orthostatic hypotension (OH), a blood pressure drop after postural change, is associated with impaired standing balance and falls in older adults
The few studies so far that investigated the relation between blood pressure (BP) change and standing balance [3, 11, 20, 21] showed increased Center of Mass (CoM) movement during stance in both community-dwelling older adults and Parkinson patients with OH compared to patients without OH [3, 21]
The aim of this study was to assess the association between BP change and the quality of standing balance, directly after postural change in a clinically relevant population of geriatric outpatients
Summary
Orthostatic hypotension (OH), a blood pressure drop after postural change, is associated with impaired standing balance and falls in older adults. The few studies so far that investigated the relation between BP change and standing balance [3, 11, 20, 21] showed increased Center of Mass (CoM) movement during stance in both community-dwelling older adults and Parkinson patients with OH compared to patients without OH [3, 21]. Previous studies addressed measures of standing balance i.e., CoM movement, maintenance of balance during semi-tandem stance and self-reported balance in relation to orthostatic BP change [3, 11, 20, 21]. Literature on the relation between OH, BP change and the quality of standing balance and the relation between BP change and the quality of standing balance directly after standing up in geriatric outpatients is currently lacking
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