Andrea S Méndez1, Jesús D Melgarejo1, Luis J Mena2, Carlos A Chávez1, Alicex C González3, José Boggia4, Joseph D Terwilliger5,6,7,8,9, Joseph H Lee7,10,11, Gladys E Maestre1,12. 1. Laboratory of Neurosciences, School of Medicine and Institute for Biological Research, University of Zulia, Zulia, Venezuela. 2. Departament of Informatics, Universidad Politécnica de Sinaloa, Mazatlán, México. 3. Cardiovascular Instituto (IECLUZ), University of Zulia, Zulia, Venezuela. 4. Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay. 5. Department of Genetics and Development, Columbia University, New York, New York, USA. 6. Department of Psychiatry, Columbia University, New York, New York, USA. 7. G.H. Sergievsky Center, Columbia University, New York, New York, USA. 8. Division of Medical Genetics, New York State Psychiatric Institute, New York, New York, USA. 9. Division of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland. 10. The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA. 11. Department of Epidemiology, School of Public Health, Columbia University, New York, New York, USA. 12. Department of Biomedical Sciences, Division of Neurosciences, and Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, Texas, USA.
Abstract
BACKGROUND: Orthostatic hypotension (OH) occurs when mechanisms regulating blood pressure (BP) levels after standing-up are altered. It is unclear how prevalence and risk factors for OH are different between sexes. We aimed to investigate sex differences in prevalence and risk factors for OH elderly individuals. METHODS: We included 882 participants from Maracaibo Aging Study. OH was a sustained reduction of ≥20 mm Hg in systolic BP, ≥10 mm Hg in diastolic BP, or both, after 3 minutes of changing positions from supine to standing. Multivariable logistic regression models were used to examine the relationships among risk factors for OH in men and women considering interaction sex-term and stratified by sex. RESULTS: The mean age was 66.7 ± 8.5 years, being similar by sex. Women and men 55-74 years had similar prevalence of OH+ (18.5% vs. 20.9%, respectively). After 75 years, the proportion of women with OH+ was lower than men (11% vs. 30%, respectively). Hypertension, specifically systolic BP ≥140 mm Hg, and high pulse pressure (PP) were related with OH+ accounted by interaction sex-term, while diastolic BP ≥90 mm Hg, antihypertensive treatment, body mass index (BMI), diabetes mellitus and age were not. Systolic BP ≥140 mm Hg increases the risk of OH only among women, while BMI showed an inverse association in both sexes. CONCLUSIONS: Although the prevalence of OH is similar in both sexes, there are different risk factors associated by sex. Systolic BP ≥140 mm Hg was associated with increased risk of OH only with women while BMI was a protective factor for OH in men and women.
BACKGROUND:Orthostatic hypotension (OH) occurs when mechanisms regulating blood pressure (BP) levels after standing-up are altered. It is unclear how prevalence and risk factors for OH are different between sexes. We aimed to investigate sex differences in prevalence and risk factors for OH elderly individuals. METHODS: We included 882 participants from Maracaibo Aging Study. OH was a sustained reduction of ≥20 mm Hg in systolic BP, ≥10 mm Hg in diastolic BP, or both, after 3 minutes of changing positions from supine to standing. Multivariable logistic regression models were used to examine the relationships among risk factors for OH in men and women considering interaction sex-term and stratified by sex. RESULTS: The mean age was 66.7 ± 8.5 years, being similar by sex. Women and men 55-74 years had similar prevalence of OH+ (18.5% vs. 20.9%, respectively). After 75 years, the proportion of women with OH+ was lower than men (11% vs. 30%, respectively). Hypertension, specifically systolic BP ≥140 mm Hg, and high pulse pressure (PP) were related with OH+ accounted by interaction sex-term, while diastolic BP ≥90 mm Hg, antihypertensive treatment, body mass index (BMI), diabetes mellitus and age were not. Systolic BP ≥140 mm Hg increases the risk of OH only among women, while BMI showed an inverse association in both sexes. CONCLUSIONS: Although the prevalence of OH is similar in both sexes, there are different risk factors associated by sex. Systolic BP ≥140 mm Hg was associated with increased risk of OH only with women while BMI was a protective factor for OH in men and women.
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