Blood Pressure Drop Rate After Standing Up Is Associated With Frailty and Number of Falls in Geriatric Outpatients.

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  • Additional Information
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford : Wiley-Blackwell
    • Subject Terms:
      Accidental Falls* ; Blood Pressure* ; Frail Elderly* ; Outpatients* ; Standing Position*; Frailty/*physiopathology ; Hypotension, Orthostatic/*physiopathology; Age Factors ; Aged ; Aged, 80 and over ; Baroreflex ; Cross-Sectional Studies ; Female ; Frailty/complications ; Frailty/diagnosis ; Geriatric Assessment ; Humans ; Hypotension, Orthostatic/complications ; Hypotension, Orthostatic/diagnosis ; Male ; Netherlands ; Risk Assessment ; Risk Factors
    • Abstract:
      Background The relationship between orthostatic hypotension and clinical outcome in older adults is poorly understood. Blood pressure drop rate (ie, speed of blood pressure drop) may particularly reflect the imposed challenge to the baroreflex and the associated clinical outcome (ie, frailty and number of falls). This study aimed to compare orthostatic blood pressure drop rate and drop magnitude with regard to their association with frailty and number of falls. Methods and Results Blood pressure was measured continuously during a standardized active stand task in 168 patients (mean age 81.4±7.0; 55.4% female) who visited a geriatric outpatient clinic for cognitive or mobility problems. The association of orthostatic blood pressure drop rate, blood pressure drop magnitude, and baroreflex sensitivity (ie, increase in heart rate divided by systolic blood pressure drop magnitude) with frailty (Fried criteria and 4 frailty markers) and self-reported number of falls was assessed using linear regression models, adjusting for age and sex. Systolic blood pressure drop rate had the strongest association with frailty according to the 4 frailty markers (β 0.30; 95% CI, 0.11-0.49; P =0.003) and number of falls (β 1.09; 95% CI, 0.19-1.20; P =0.018); diastolic blood pressure drop magnitude was most strongly associated with frailty according to the Fried criteria (β 0.37; 95% CI, 0.15-0.60; P <0.001). Baroreflex sensitivity was associated with neither frailty nor number of falls. Conclusions Orthostatic blood pressure drop rate was associated with frailty and falls and may reflect the challenge to the baroreflex rather than drop magnitude.
    • Comments:
      Comment in: J Am Heart Assoc. 2020 Apr 7;9(7):e016222. (PMID: 32223391)
    • References:
      J Psychiatr Res. 1975 Nov;12(3):189-98. (PMID: 1202204)
      J Hypertens. 2010 Jul;28(7):1498-505. (PMID: 20453669)
      JAMA. 1963 Sep 21;185:914-9. (PMID: 14044222)
      Front Neurosci. 2019 Jul 09;13:694. (PMID: 31338017)
      J Gerontol A Biol Sci Med Sci. 2005 Sep;60(9):1157-62. (PMID: 16183956)
      J Am Med Dir Assoc. 2016 Apr 1;17(4):371.e7-12. (PMID: 26922807)
      Clin Auton Res. 2015 Oct;25(5):277-84. (PMID: 26280217)
      Clin Auton Res. 2011 Apr;21(2):69-72. (PMID: 21431947)
      Am J Physiol Heart Circ Physiol. 2008 Mar;294(3):H1304-9. (PMID: 18192213)
      PLoS One. 2014 Sep 15;9(9):e106808. (PMID: 25222275)
      J Am Coll Cardiol. 2018 Sep 11;72(11):1294-1309. (PMID: 30190008)
      J Am Heart Assoc. 2020 Apr 7;9(7):e014688. (PMID: 32223397)
      J Geriatr Cardiol. 2019 Mar;16(3):272-279. (PMID: 31080470)
      Occup Med (Lond). 2014 Jul;64(5):393-4. (PMID: 25005549)
      J Am Geriatr Soc. 2011 Apr;59(4):655-65. (PMID: 21438868)
      Lancet. 1999 Jan 16;353(9148):205-6. (PMID: 9923878)
      Age Ageing. 2002 May;31(3):181-6. (PMID: 12006306)
      Am J Physiol Heart Circ Physiol. 2013 Apr 1;304(7):H1038-44. (PMID: 23355343)
      Age Ageing. 2001 Jul;30(4):289-93. (PMID: 11509305)
      Ageing Res Rev. 2018 Dec;48:122-144. (PMID: 30394339)
      Clin Auton Res. 2016 Feb;26(1):41-8. (PMID: 26695401)
      Exp Gerontol. 2019 Jun;120:40-49. (PMID: 30825549)
      Anesthesiology. 2015 Nov;123(5):1198-208. (PMID: 26402848)
      J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. (PMID: 11253156)
      J Am Med Dir Assoc. 2019 May;20(5):589-597.e5. (PMID: 30583909)
      Geriatr Gerontol Int. 2019 Jun;19(6):525-529. (PMID: 31020795)
      PLoS One. 2009;4(5):e5521. (PMID: 19436724)
      Blood Press Monit. 2007 Jun;12(3):167-71. (PMID: 17496466)
      Age Ageing. 2017 May 1;46(3):439-445. (PMID: 28013227)
      Comput Math Methods Med. 2019 Feb 3;2019:4875231. (PMID: 30863454)
      J Am Heart Assoc. 2018 Nov 6;7(21):e010060. (PMID: 30608209)
      J Gerontol A Biol Sci Med Sci. 2013 May;68(5):581-9. (PMID: 23070881)
    • Contributed Indexing:
      Keywords: baroreflex; blood pressure; blood pressure measurement/monitoring; falls; frailty; geriatrics; orthostatic hypotension
    • Publication Date:
      Date Created: 20200401 Date Completed: 20210308 Latest Revision: 20210308
    • Publication Date:
      20231215
    • Accession Number:
      PMC7428630
    • Accession Number:
      10.1161/JAHA.119.014688
    • Accession Number:
      32223397