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Orthostatic hypotension (OH) and mortality in relation to age, blood pressure and frailty.
MedLine Citation:
PMID:  22240412     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Systolic hypertension and OH, as with many other deficits, accumulate with age. This deficit accumulation results in frailty: enhanced vulnerability to adverse outcomes. This study evaluated OH in relation to age, frailty, systolic hypertension, and mortality. In the population-based Canadian Study of Health and Aging second clinical examination, complete data were available on 1347 people, mean age=83.3 (SD=6.4)years. A frailty index (FI) was calculated from a 52-item Comprehensive Geriatric Assessment (CGA), yielding an FI-CGA from 0 (no deficits) to 1.0 (52 deficits). The mean change in blood pressure from lying to standing was 7.3±15.6mmHg (range +94 to -60). In total, 239 people (17.7%) had OH (change >20mmHg systolic or >10mmHg diastolic). Mean systolic blood pressure was higher (155.8±23.3mmHg) in people with OH than in those without (141.4±23mmHg), as was the FI-CGA (0.18 vs. 0.16). OH increased with frailty and systolic hypertension, but not age. Unadjusted, OH was associated with an increased risk of death (relative risk=1.21, 95% confidence interval 1.19-1.23). Adjusted for frailty, this result was not significant. OH may be a marker of the system dysregulation seen in frailty, but as a state variable is a less powerful marker of vulnerability than is the FI-CGA.
Authors:
Michael R H Rockwood; Susan E Howlett; Kenneth Rockwood
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-10
Journal Detail:
Title:  Archives of gerontology and geriatrics     Volume:  -     ISSN:  1872-6976     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214379     Medline TA:  Arch Gerontol Geriatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Division of Geriatric Medicine, Dalhousie University, Faculty of Medicine, Halifax, Nova Scotia, Canada B3H 4R2.
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