Aline Guérin1, Marie-Laure Bureau1, Nisrin Ghazali1, Raphaëlle Gervais1, Evelyne Liuu1, Florent Seité1, Fabienne Bellarbre2, Pierre Ingrand3,4, Marc Paccalin5. 1. Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France. 2. Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France. fabienne.bellarbre@chu-poitiers.fr. 3. Pôle Biologie, Pharmacie et Santé Publique, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France. 4. INSERM, CIC-P 1402, Centre Hospitalier Universitaire de Poitiers, Poitiers, France. 5. Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France. m.paccalin@chu-poitiers.fr.
Abstract
OBJECTIVE: To assess the factors associated with orthostatic hypotension (OH) in hospitalized elderly patients. DESIGN: Prospective observational single center study. SETTING: A French academic center. PARTICIPANTS: One hundred and thirty-one patients without OH symptoms who underwent OH testing. MEASUREMENTS: The OH test was performed when the patient was able to get out of the bed and was no longer receiving parenteral fluids. The blood pressure was measured after a 10-min rest while the patients were sitting and then standing at 1 and 3 min. Demographic data, co-morbidities, current medications and biological parameters were recorded. RESULTS: The mean patient age was 84.3 ± 7 years. The mean CIRS-G score was 10.6 ± 3.8. The OH test was performed 6.3 ± 3.9 days after admission and was positive in 39 (29.8 %) patients (95 % confidence interval (CI) 22, 38) and positive at 1 min in 87.2 % of the cases. Multivariate analysis showed that OH prevalence correlated with diabetes (odds ratio (OR) = 4.23; 95 % CI 1.10, 16.24; P = 0.03), serum 25-hydroxyvitamin D <20 ng/ml (OR = 3.38; 95 % CI 1.36, 8.42; P = 0.008), use of tranquilizers (anxiolytic and hypnotic) (OR = 2.96; 95 % CI 1.18, 7.4; P = 0.02), CIRS-G score (OR = 1.15; 95 % CI 1.01, 1.31; P = 0.03) and lack of diuretics (OR = 0.20; 95 % CI 0.06, 0.63; P = 0.005). CONCLUSION: In older adults, OH is often misdiagnosed because it is asymptomatic. As practitioners may be reluctant to perform the OH test because of time constraints, targeting a subgroup of patients with a higher risk of OH should be worthwhile to prevent further OH complications.
OBJECTIVE: To assess the factors associated with orthostatic hypotension (OH) in hospitalized elderly patients. DESIGN: Prospective observational single center study. SETTING: A French academic center. PARTICIPANTS: One hundred and thirty-one patients without OH symptoms who underwent OH testing. MEASUREMENTS: The OH test was performed when the patient was able to get out of the bed and was no longer receiving parenteral fluids. The blood pressure was measured after a 10-min rest while the patients were sitting and then standing at 1 and 3 min. Demographic data, co-morbidities, current medications and biological parameters were recorded. RESULTS: The mean patient age was 84.3 ± 7 years. The mean CIRS-G score was 10.6 ± 3.8. The OH test was performed 6.3 ± 3.9 days after admission and was positive in 39 (29.8 %) patients (95 % confidence interval (CI) 22, 38) and positive at 1 min in 87.2 % of the cases. Multivariate analysis showed that OH prevalence correlated with diabetes (odds ratio (OR) = 4.23; 95 % CI 1.10, 16.24; P = 0.03), serum 25-hydroxyvitamin D <20 ng/ml (OR = 3.38; 95 % CI 1.36, 8.42; P = 0.008), use of tranquilizers (anxiolytic and hypnotic) (OR = 2.96; 95 % CI 1.18, 7.4; P = 0.02), CIRS-G score (OR = 1.15; 95 % CI 1.01, 1.31; P = 0.03) and lack of diuretics (OR = 0.20; 95 % CI 0.06, 0.63; P = 0.005). CONCLUSION: In older adults, OH is often misdiagnosed because it is asymptomatic. As practitioners may be reluctant to perform the OH test because of time constraints, targeting a subgroup of patients with a higher risk of OH should be worthwhile to prevent further OH complications.
Authors: Stephen P Juraschek; Lara M Simpson; Barry R Davis; Jennifer L Beach; Anthony Ishak; Kenneth J Mukamal Journal: Hypertension Date: 2019-09-03 Impact factor: 10.190
Authors: Franca Barbic; Karsten Heusser; Maura Minonzio; Dana Shiffer; Beatrice Cairo; Jens Tank; Jens Jordan; André Diedrich; Peter Gauger; Roberto Antonio Zamuner; Alberto Porta; Raffaello Furlan Journal: Front Physiol Date: 2019-08-23 Impact factor: 4.566