Abstract
Objective: Orthostatic hypotension (OH) is a debilitating condition that is associated with decreased quality of life and increase all-cause mortality. There is insufficient information about OH in elderly Latinos. The aim of the present study was to determine the prevalence and risk factors for OH in community-dwelling elders from the Maracaibo Aging Study (MAS), Venezuela. Design and method: The MAS is a population-based study of community-dwelling individuals aged 55 years or older. The MAS included 2437 participants who underwent standardized assessments. Randomly selected, 887 subjects completed the OH protocol. OH was defined as a drop in systolic blood pressure (BP) of 20 mm Hg or more or a drop in diastolic BP of 10 mmHg after standing for 1, 3, or 5 minutes. Pulse pressure (PP) was the difference between systolic and diastolic BP. One-way ANOVA and χ2 tests were used for data analysis. Multivariate logistic regression model, adjusting for age, sex, smoking, obesity, hyperhomocysteinemia, heart rate (HR) and PP was performed to determine risk factors for OH. Results: The mean age of subjects was 66.6 yrs, and 62% were women. Hypertension was highly prevalent (80.3%), and one-third of the participants were obese. Prevalence of OH was 45% and doubled from 33% in the younger (55–64 y) group to 68.5% in the older (>75 y) group. The most common type was systolic OH (43%) compared with diastolic OH (26.5%) or combined systolic and diastolic (30.5%). All subjects with OH were hypertensive, 32% received treatment, and none of those treated had their BP controlled. Multivariate analysis revealed that, in the younger group, high HR (OR = 7.58 95% CI = 1.97 – 29.09) and PP (OR = 1.21, 95% CI = 1.16 – 1.26) were significantly associated with high risk of OH. Other confounders contributed to risk, including sex (OR = 0.20, 95% CI = 0.09 – 0.42) and smoking (OR = 0.44, 95% CI = 0.20 – 0.96). In the old group, only PP was associated with OH. Conclusions: Elderly participants of the MAS have a high prevalence of hypertension, and high rates OH. Male sex, high HR and high PP were risk factors for OH, while smoking was protective.
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