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Effect of Elapsed Time after Standing up on Orthostatic Blood Pressure Change in the Elderly Yasuharu Tabara1), Katsuhiko Kohara2), Michie Ohnishi2), Shouzoh Ueki3), Hiromitsu Yano4), Yoshikuni Yamamoto1), Michiya Igase1), Hidehisa Yamagata1), Jun Nakura1) and Tetsuro Miki1) The effect of time elapsed after standing on the orthostatic change in blood pressure was investigated. The study subjects were recruited from 237 community-dwelling elderly residents free from any history of cardiovascular disease and not on medication. Basal blood pressure was determined by averaging two determinations of supine blood pressure measured with an automatic oscillometric blood pressure recorder after resting for more than 10 minutes. Orthostatic change in systolic blood pressure (SBP) was determined as more than a 10% increase or decrease in SBP after standing. In the total population, maximum change in SBP was observed at 1 minute after standing-up. However, 8.4% and 7.2% of subjects showed abnormal increase or decrease in SBP only after 3 minutes. These results suggests that orthostatic dysregulation of blood pressure could be evaluated by measuring at 1 minute after standing up. However, if abnormal variation of blood pressure was not observed at 1 minute after standing up, repeated measurement at 3 minutes would be necessary.

Background: Orthostatic dysregulation of blood pressure (BP) has been shown to be associated with an increased incidence of future cardiovascular disease, stroke and even mortality. To make a meaningful assessment of this association, we evaluated the effect of time elapsed after standing on any change in orthostatic BP. Methods:This study concerns 237 community-dwelling elderly people free from any history or symptoms of cardiovascular disease and not on medication. Basal BP was determined by averaging two determinations of supine BP measured with an automatic oscillometric BP recorder after resting for more than 10 min. Orthostatic change in BP was determined at 1 min and 3 min intervals after standing up. Results:The orthostatic change in systolic BP (∆SBP) had a Gaussian distribution with a pivot at 1.2 ± 14 mmHg. The prevalence of subjects showing more than a 10% decrease in SBP at the 1-min interval was 14.3% (34 subjects). At the 3-min interval, 11 of them showed ∆SBP within ± 10%. However, another 17 subjects (7.2%) were newly diagnosed as having orthostatic hypotensive disorder. Similarly, 17.3% (41 cases) of subjects showed more than a 10% increase in ∆SBP at the 1-min interval. Among them, 22 (9.3%) subjects showed ∆SBP within ± 10% at the 3-min interval. However, another 20 (8.4%) subjects were newly diagnosed as having orthostatic hypertensive disorder. Conclusion:These results suggests that orthostatic dysregulation of BP could be evaluated by measuring at 1-min interval. However, if abnormal variation of BP was not observed, repeated measurement at 3 min would be necessary.

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