Prevalence of orthostatic hypotension in patients aged 80 or over and associated risk factors

Abstract

Objective To investigate the prevalence of orthostatic hypotension in hypertensive patients aged 80 or over and associated risk factors at level A tertiary hospitals. Methods A multi-center cross-sectional study was conducted among very old hypertensive patients(≥80 years) at 28 level A tertiary hospitals by using questionnaire-based surveys. A total of 1298 hypertensive subjects aged between 80 and 101 years were enrolled in this study. Blood pressures was measured in the supine position and the upright position within three minutes of standing, and 316 patients were assigned to the orthostatic hypotension(OH) group and the other 982 patients to the non-orthostatic hypotension(NOH) group. Additional information was acquired through patients' medical records and the questionnaire. Results The prevalence of OH was 24.3%(316 cases) There were no significan different betueen OH patienl with NOHones in gender and age.OH patients had higher supine systolic and diastolic blood pressure(P=0.003 and 0.000, respectively), lower standing systolic and diastolic blood pressure(P=0.000 and 0.000, respectively), and higher rates of past coronary heart disease, stroke and renal abnormalities(P=0.037, 0.001 and 0.014, respectively) than NOH patients. Logistic regression analysis showed that the prevalence of OH in the patients was positively correlated with supine systolic blood pressure(OR=1.196, CI: 1.153-1.242, P=0.000) and supine diastolic blood pressure(OR=1.740, CI: 1.602-1.885, P=0.000) and was negatively correlated with standing systolic blood pressure(OR=0.824, CI: 0.795-0.855, P=0.000) and standing diastolic blood pressure(OR=0.584, CI: 0.539-0.634, P=0.000). Conclusions The prevalence of orthostatic hypotension is high in hypertensive patients aged 80 years or over at level A tertiary hospitals. Poor blood pressure control may increase the risk of orthostatic hypotension. Key words: Elderly, aged over 80 years; Hypertension; Hypotension