| 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. | |
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MedLine Citation:
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PMID: 21391928 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Anupama Gangavati; Ihab Hajjar; Lien Quach; Richard N Jones; Dan K Kiely; Peggy Gagnon; Lewis A Lipsitz |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of the American Geriatrics Society Volume: 59 ISSN: 1532-5415 ISO Abbreviation: J Am Geriatr Soc Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-11 Completed Date: 2011-06-02 Revised Date: 2012-03-21 |
Medline Journal Info:
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Nlm Unique ID: 7503062 Medline TA: J Am Geriatr Soc Country: United States |
Other Details:
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Languages: eng Pagination: 383-9 Citation Subset: IM |
Copyright Information:
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© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society. |
Affiliation:
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Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. agangava@bidmc.harvard.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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J Am Geriatr Soc. 2011 May;59(5):960 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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