OBJECTIVES: To investigate the relationships between uncontrolled and controlled hypertension, orthostatic hypotension (OH), and falls in participants of the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study (N=722, mean age 78.1). DESIGN: Prospective population-based study. SETTING: Community. PARTICIPANTS: Seven hundred twenty-two adults aged 70 and older living within a 5-mile radius of the study headquarters at Hebrew Rehabilitation Center in Boston. MEASUREMENTS: Blood pressure (BP) was measured at baseline in the supine position and after 1 and 3 minutes of standing. Systolic OH (SOH) and diastolic OH at 1 and 3 minutes were defined as a 20-mmHg decline in systolic BP and a 10-mmHg decline in diastolic BP upon standing. Hypertension was defined as BP of 140/90 mmHg or greater or receiving antihypertensive medications (controlled if BP < 140/90 mmHg and uncontrolled if ≥ 140/90 mmHg). Falls data were prospectively collected using monthly calendars. Fallers were defined as those with at least two falls within 1 year of follow-up. RESULTS: OH was highest in participants with uncontrolled hypertension; SOH at 1 minute was 19% in participants with uncontrolled hypertension, 5% in those with controlled hypertension, and 2% in those without hypertension (P ≤ .001)). Participants with SOH at 1 minute and uncontrolled hypertension were at greater risk of falls (hazard ratio=2.5, 95% confidence interval = 1.3-5.0) than those with uncontrolled hypertension without OH. OH by itself was not associated with falls. CONCLUSION: Older adults with uncontrolled hypertension and SOH at 1 minute are at greater risk for falling within 1 year. Hypertension control, with or without OH, is not associated with greater risk of falls in older community-dwelling adults.
OBJECTIVES: To investigate the relationships between uncontrolled and controlled hypertension, orthostatic hypotension (OH), and falls in participants of the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study (N=722, mean age 78.1). DESIGN: Prospective population-based study. SETTING: Community. PARTICIPANTS: Seven hundred twenty-two adults aged 70 and older living within a 5-mile radius of the study headquarters at Hebrew Rehabilitation Center in Boston. MEASUREMENTS: Blood pressure (BP) was measured at baseline in the supine position and after 1 and 3 minutes of standing. Systolic OH (SOH) and diastolic OH at 1 and 3 minutes were defined as a 20-mmHg decline in systolic BP and a 10-mmHg decline in diastolic BP upon standing. Hypertension was defined as BP of 140/90 mmHg or greater or receiving antihypertensive medications (controlled if BP < 140/90 mmHg and uncontrolled if ≥ 140/90 mmHg). Falls data were prospectively collected using monthly calendars. Fallers were defined as those with at least two falls within 1 year of follow-up. RESULTS: OH was highest in participants with uncontrolled hypertension; SOH at 1 minute was 19% in participants with uncontrolled hypertension, 5% in those with controlled hypertension, and 2% in those without hypertension (P ≤ .001)). Participants with SOH at 1 minute and uncontrolled hypertension were at greater risk of falls (hazard ratio=2.5, 95% confidence interval = 1.3-5.0) than those with uncontrolled hypertension without OH. OH by itself was not associated with falls. CONCLUSION: Older adults with uncontrolled hypertension and SOH at 1 minute are at greater risk for falling within 1 year. Hypertension control, with or without OH, is not associated with greater risk of falls in older community-dwelling adults.
Authors: Elizabeth J Samelson; Jennifer L Kelsey; Douglas P Kiel; Anthony M Roman; L Adrienne Cupples; Marcie B Freeman; Richard N Jones; Marian T Hannan; Suzanne G Leveille; Margaret M Gagnon; Lewis A Lipsitz Journal: Am J Epidemiol Date: 2008-10-25 Impact factor: 4.897
Authors: K Kario; J N Tobin; L I Wolfson; R Whipple; C A Derby; D Singh; P R Marantz; S Wassertheil-Smoller Journal: J Am Coll Cardiol Date: 2001-07 Impact factor: 24.094
Authors: Maartje H de Groot; Jos P C M van Campen; Marije A Moek; Linda R Tulner; Jos H Beijnen; Claudine J C Lamoth Journal: Drugs Aging Date: 2013-11 Impact factor: 3.923
Authors: Stephen P Juraschek; Natalie Daya; Lawrence J Appel; Edgar R Miller; Beverly Gwen Windham; Lisa Pompeii; Michael E Griswold; Anna Kucharska-Newton; Elizabeth Selvin Journal: Am J Hypertens Date: 2016-09-16 Impact factor: 2.689
Authors: Mary E Tinetti; Ling Han; David S H Lee; Gail J McAvay; Peter Peduzzi; Cary P Gross; Bingqing Zhou; Haiqun Lin Journal: JAMA Intern Med Date: 2014-04 Impact factor: 21.873
Authors: Stephen P Juraschek; Lawrence J Appel; Edgar R Miller; Kenneth J Mukamal; Lewis A Lipsitz Journal: Hypertension Date: 2018-10 Impact factor: 10.190
Authors: Gail McAvay; Heather G Allore; Andrew B Cohen; Danijela Gnjidic; Terrence E Murphy; Mary E Tinetti Journal: J Am Geriatr Soc Date: 2017-09-14 Impact factor: 5.562
Authors: Jeff D Williamson; Mark A Supiano; William B Applegate; Dan R Berlowitz; Ruth C Campbell; Glenn M Chertow; Larry J Fine; William E Haley; Amret T Hawfield; Joachim H Ix; Dalane W Kitzman; John B Kostis; Marie A Krousel-Wood; Lenore J Launer; Suzanne Oparil; Carlos J Rodriguez; Christianne L Roumie; Ronald I Shorr; Kaycee M Sink; Virginia G Wadley; Paul K Whelton; Jeffrey Whittle; Nancy F Woolard; Jackson T Wright; Nicholas M Pajewski Journal: JAMA Date: 2016-06-28 Impact factor: 56.272