Standing Up Slowly Antagonises Initial Blood Pressure Decrease in Older Adults with Orthostatic Hypotension

Gerontology. 2017;63(2):137-143. doi: 10.1159/000450642. Epub 2016 Oct 19.

Abstract

Background: Orthostatic hypotension (OH) is common in older adults and associated with increased morbidity and mortality, loss of independence and high health-care costs. Standing up slowly is a recommended non-pharmacological intervention. However, the effectiveness of this advice has not been well studied.

Objectives: The aim of this study was to investigate whether standing up slowly antagonises posture-related blood pressure (BP) decrease in a clinically relevant population of geriatric outpatients.

Methods: In this cross-sectional study, 24 community-dwelling older adults referred to a geriatric outpatient clinic and diagnosed with OH were included. BP was measured continuously during 3 consecutive transitions from supine to standing position during normal, slow and fast transition.

Results: The relative BP decrease at 0-15 s after slow transition was significantly lower than after normal transition (p = 0.003 for both systolic BP and diastolic BP) and fast transition (p = 0.045 for systolic BP; diastolic BP: non-significant). The relative diastolic BP decrease at 60-180 s after normal transition was significantly lower than after fast transition (p = 0.029).

Conclusion: Standing up slowly antagonises BP decrease predominantly during the first 15 s of standing up in a clinically relevant population of geriatric outpatients diagnosed with OH. Results support the non-pharmacological intervention in clinical practice to counteract OH.

MeSH terms

  • Accidental Falls / prevention & control
  • Aged
  • Aged, 80 and over
  • Aging / physiology
  • Blood Pressure / physiology
  • Blood Pressure Determination / methods
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypotension, Orthostatic / physiopathology*
  • Hypotension, Orthostatic / prevention & control*
  • Male
  • Posture / physiology*
  • Time Factors