Prevalence of orthostatic hypotension in non-institutionalised elderly aged 80 and over. A diagnostic study using an oscillometric device

Abstract

Background: Orthostatic hypotension (OH) is a common disorder, and possibly underdiagnosed. In the elderly, OH has been considered a common cause of falls, fractures, and fear of falling. Its prevalence increases with age, probably related to the number of drug treatments, decreased fluid intake, and the progressive dysfunction of the autonomic nervous system.

Objectives: To evaluate the prevalence of OH in a non-institutionalised population ≥80 years, according to different criteria based on sequential measurements taken at minute 0, 1, 3 and 5 of standing.

Methods design: A diagnostic accuracy study using an oscillometric device.

Setting and participants: Convenience sampling of 176 people ≥80 years attended in an urban Primary Health Care Centre.

Measurements: Supine and standing blood pressure (BP) measurements, at minutes 0, 1, 3 and 5 using the OMRON 705-CP blood pressure device. OH definition: decrease ≥20mmHg in systolic BP (SBP) and/or ≥10mmHg in diastolic BP (DBP).

Results: Mean age (Standard Deviation) was 85.2 (3.7) years, and 60.2% were women. Prevalence of OH: 30.7% at minute 0; 19.3% at minute 1; 18.2% at minute 3; and 20.5% at minute 5. Age, sedentary life, smoking, diabetes and SBP values were significantly associated with a greater BP decrease at minute 0.

Conclusion: A third of the sample had OH, with a maximum prevalence at minute 0. From a clinical point of view, it is suggested that the definition of OH is prioritized according to the BP at minute 0.

Keywords: Ancianos; Atención primaria; Blood pressure; Elderly; Hipotensión ortostática; Orthostatic hypotension; Presión arterial; Primary health care.