Abstract
Abstract Background Orthostatic Hypotension (OH) is an important cause of falls in older people, with patients typically presenting with postural dizziness/light-headedness. However, while we recognise clinically that in older patients with OH, symptoms are often absent or atypical, little work to date has captured this spectrum of OH symptoms. The aim of this study therefore was to examine symptom profiles in a large cohort of older people with severe OH and ascertain the prevalence of ‘asymptomatic’ OH. Methods We included a consecutive cohort of older patients (aged ≥60 years) with severe OH attending a tertiary referral falls unit. OH, was identified during an active stand using a Finometer® measuring beat-to-beat phasic blood pressure. Patients were asked to report any symptoms during the test and each symptom was recorded. Severe OH was defined as failure of recovery of BP to within 20 mmHg systolic/10mmHg diastolic of baseline value within 3 minutes of standing. Results 71% of patients (n=393) reported symptoms during the active stand, with two thirds of these reporting ≥2 symptoms. The most frequent reported symptoms were dizziness (52%) and poor balance (52%), followed by weakness (38%), visual disturbance (28%), light-headedness (21%), fatigue (6%), nausea (4%), feeling warm (4%) and palpitations (1%). Nurses reported pallor in 13% of patients, while 3% needed to lie down due to hypotension/presyncope. Average time to symptom reporting was 16 seconds (compared to 11 seconds in patients who did not have severe OH). Conclusion Almost one third with severe OH reported no symptoms during an active stand, while only half reported ‘typical’ OH symptoms of dizziness/light-headedness. Atypical symptoms such as fatigue, and generalised weakness are relatively common. Atypical symptomatology is therefore frequent in older patients with severe OH. These findings have important implications for the clinical assessment of older people with falls.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.