Correlates of Postural Hypotension in a Community Sample of Elderly Blacks and Whites

Abstract

Postural hypotension is thought to be prevalent among the elderly, but few community-based studies of this condition have been conducted. In addition, little is known about postural hypotension in blacks despite well documented racial differences in hypertension and stroke. Data on 659 elderly (greater than or equal to 60 years of age) participants in a survey of two rural, biracial townships were analyzed to describe the frequency and correlates of postural hypotension. Twelve percent of the 659 adults experienced a drop of 10 mmHg or greater in systolic blood pressure on going from sitting to standing (supine measures were not available). This degree of postural hypotension was twice as common for whites as for blacks (14.5% vs 7.5%, P = 0.01). Postural hypotension was associated with elevated sitting blood pressure and showed positive but statistically non-significant relationships with anti-hypertensive medications and leanness. The association between race and postural hypotension persisted after adjusting for these and other risk factors (OR = 2.2, 95% CI:1.2,4.0).

Prevalence and correlates of orthostatic hypotension in middle-aged men and women in Korea: the Korean Health and Genome Study

“…[1][2][3]5,6,10,11,13,14 In the current report, lower BMI was positively related to an excess in the odds of OH. Although findings were adjusted for age, hypertension, diabetes, cigarette smoking, total cholesterol, HDL cholesterol, and triglycerides, other unknown comorbidities in leaner individuals are likely to have contributed to this finding.…”

“…In the Systolic Hypertension in the Elderly Project (SHEP) 13 and the Cardiovascular Health Study, 4 no significant differences were observed in the prevalence of OH between ethnic groups, mainly composed of Caucasian and Black individuals. In a survey in two rural communities, however, prevalence of OH was twice as common in elderly Caucasians as compared to Blacks, 14 while in the ARIC study, 1,2 systolic OH was observed to be higher in Blacks than in Caucasians.…”

“…Most studies of OH have focused on the elderly, [3][4][5][6][8][9][10][11][12][13][14][15] where reported prevalence ranges from 5 to 30%. Unfortunately, the use of different methods to define OH makes it difficult to compare study findings.…”

“…[1][2][3][4][5][6][7] Depending on how OH is measured, however, prevalence can range markedly from 5 to 30%, [3][4][5][6][7][8][9][10][11][12][13][14][15] making it difficult to describe cross-cultural variation or to identify effects that may be associated with OH. 1,2,4,14,15 Low rates of coronary heart disease in Asia vs the US and Western Europe suggest that the prevalence and correlates of OH may also be different through associations with risk factors that are culturally unique. Unfortunately, few studies of OH have been conducted in Asia, and none have occurred in a general population setting in Korea.…”

Association between the blood pressure response to a change in posture and the 6-year incidence of hypertension: prospective findings from the ARIC study

“…12 Orthostatic hypotension (OH), or a large decrease in blood pressure in response to a change in posture, has been inconsistently associated with elevated blood pressure in cross-sectional studies. [13][14][15][16] This study examined whether DSBP (increases and decreases) and OH were predictive of hypertension in a normotensive, bi-ethnic population-based sample of middle-aged men and women, followed over a period of approximately 6 years. As blood pressure reactivity is sometimes reported to be higher among those with higher levels of resting blood pressure, 17 we also tested the hypothesis that associations would be stronger among those with higher levels of baseline, seated blood pressure.…”