Document Detail

First morning standing up may be risky in acutely ill older inpatients.
MedLine Citation:
PMID:  16036493     Owner:  NLM     Status:  MEDLINE    
Information about orthostatic hypotension (OH) among elderly patients hospitalized for acute conditions in short-term facilities is scarce. Many older inpatients carry various predisposing factors for OH. However, its existence goes frequently unrecognized. In this context, first morning standing up following admission for an acute disease may be dangerous. The aim of this study was to investigate OH and associated manifestations in this situation. OH (> or = 20 mmHg systolic and/or (> or =10 mmHg diastolic blood pressure fall), heart rate, arrhythmias and appearance of dizziness or palpitations were recorded in 121 sequential inpatients aged >65 years, prior to and 1, 3 and 5 min following first morning standing. OH occurred in 64.5% of patients, while dizziness and/or palpitations appeared in 76%. Severe adverse effects were registered in 11.5% of OH patients. Significantly associated with OH were: bed rest lasting 9-24 h (vs (< or = 8 h, p<0.001), appearance of dizziness or palpitations (p<0.001 and p=0.005, respectively), heart failure (p=0.02) and renal dysfunction (p=0.04). OH and/or associated symptoms are frequent in acutely ill older inpatients on first morning standing up following nocturnal bed rest. The ominous potential consequences call for alertness to this phenomenon and application of appropriate preventive measures.
Oleg Gorelik; Gregory Fishlev; Vita Litvinov; Dorit Almoznino-Sarafian; Irena Alon; Miriam Shteinshnaider; Shulamit Chachashvily; David Modai; Natan Cohen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood pressure     Volume:  14     ISSN:  0803-7051     ISO Abbreviation:  Blood Press.     Publication Date:  2005  
Date Detail:
Created Date:  2005-07-22     Completed Date:  2005-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9301454     Medline TA:  Blood Press     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  139-43     Citation Subset:  IM    
Department of Internal Medicine F, Assaf Harofeh Medical Center, Zerifin, Israel.
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MeSH Terms
Acute Disease
Blood Pressure / physiology
Exercise / physiology
Heart Rate / physiology
Hypotension, Orthostatic / diagnosis*,  physiopathology*,  prevention & control
Inpatients / statistics & numerical data*
Risk Factors

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