Document Detail


Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study.
MedLine Citation:
PMID:  21391928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Anupama Gangavati; Ihab Hajjar; Lien Quach; Richard N Jones; Dan K Kiely; Peggy Gagnon; Lewis A Lipsitz
Related Documents :
15388498 - Phase-averaged characterization of respiratory sinus arrhythmia pattern.
4066578 - Ontogeny of respiratory control and pulmonary mechanics in newborn rabbits.
8366008 - Measurement of gastric and diaphragmatic height during slow breathing maneuvers.
21286758 - Hypertension and hemodialysis: pathophysiology and outcomes in adult and pediatric popu...
16361908 - Effects of reamed or unreamed intramedullary nailing under non-damaged conditions on pu...
7085428 - Demonstration of failure of body plethysmography in airway obstruction.
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  59     ISSN:  1532-5415     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-11     Completed Date:  2011-06-02     Revised Date:  2012-03-21    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-9     Citation Subset:  IM    
Copyright Information:
© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.
Affiliation:
Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. agangava@bidmc.harvard.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Accidental Falls*
Aged
Boston / epidemiology
Female
Geriatric Assessment
Humans
Hypertension / complications*,  epidemiology,  physiopathology
Hypotension, Orthostatic / complications*,  epidemiology,  physiopathology
Independent Living
Male
Prevalence
Proportional Hazards Models
Prospective Studies
Risk Factors
Grant Support
ID/Acronym/Agency:
AG004390/AG/NIA NIH HHS; AG005134/AG/NIA NIH HHS; AG025037/AG/NIA NIH HHS; AG08812/AG/NIA NIH HHS; K01HP20501-01-00//PHS HHS; K23 AG030057-05/AG/NIA NIH HHS; K23AG30057/AG/NIA NIH HHS; P01 AG004390-25/AG/NIA NIH HHS
Comments/Corrections
Erratum In:
J Am Geriatr Soc. 2011 May;59(5):960

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Effect of N-acetylcystein on pulmonary function in patients undergoing off-pump coronary artery bypa...
Next Document:  High Blood Pressure Accelerates Gait Slowing in Well-Functioning Older Adults over 18-Years of Follo...