Orthostatic hypotension in patients with late‐life depression: Prevalence and validation of a new screening tool

Shanbhag, Amruta; Awai, Helen; Rej, Soham; Thomas, Alan; Puka, Klajdi; Vasudev, Akshya

doi:10.1002/gps.4951

Cited by 5 publications

(2 citation statements)

References 39 publications

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“…Снижение мобильности является предиктором формирования зависимости от помощи окружающих, инвалидизации, когнитивного снижения, падений, госпитализаций, повышает риск смерти [18]. Выявлена ассоциация между низкой скоростью ходьбы по данным самоотчета пациентов и низким качест вом жизни, а также наличием симптомов депрессии [19]. Снижение мобильности может служить чувствительным предиктором состояния здоровья пожилых людей и важным параметром при определении объема необходимого ухода.…”

Section: хронические неинфекционные заболевания ассоциирующиеся с орunclassified

The Effects of Orthostatic Hypotension on Functional Status Parameters in Elderly and Very Elderly People

Шарашкина¹,

Рунихина²,

Ткачева³

2019

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Section: хронические неинфекционные заболевания ассоциирующиеся с орunclassified

The Effects of Orthostatic Hypotension on Functional Status Parameters in Elderly and Very Elderly People

Шарашкина¹,

Рунихина²,

Ткачева³

2019

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“…Studies on individuals with chronic SCI have identified blood pressure instability as one of the determinants of cardiovascular morbidity and mortality, including a 4-fold increased stroke risk in the SCI population (Su and Miao, 2005;Jegede et al, 2010;Rothwell et al, 2010;Wu et al, 2012;Muntner et al, 2015;Piatt et al, 2016;Stevens et al, 2016;Parati et al, 2018;Ditterline et al, 2020;Parati et al, 2020). Even in those without SCI, mounting evidence links blood pressure instability during orthostasis with poorer general physical and mental health (Wilkie et al, 1976;Wessely et al, 1990;Pilgrim et al, 1992;Rosengren et al, 1993;Barrett-Connor and Palinkas, 1994;Czajkowska et al, 2010;Vasudev et al, 2011;Regan et al, 2013;Briggs et al, 2016;Briggs et al, 2018;Shanbhag et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Novel Clinimetric Toolset to Quantify the Stability of Blood Pressure and Its Application to Evaluate Cardiovascular Function After Spinal Cord Injury

et al. 2021

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Profound dysfunction of the cardiovascular system occurs after spinal cord injury (SCI), which is a leading cause of mortality in this population. Most individuals with chronic SCI experience transient episodes of hypotensive and hypertensive blood pressure in response to daily life activities. There are currently limited tools available to evaluate the stability of blood pressure with respect to a reference range. The aim of this study was to develop a clinimetric toolset for accurately quantifying stability of the blood pressure measurements and taking into consideration the complex dynamics of blood pressure variability among individuals with SCI. The proposed toolset is based on distribution of the blood pressure data points within and outside of the clinically recommended range. This toolset consists of six outcome measures including 1) total deviation of the 90% of the blood pressure data points from the center of the target range (115 mmHg); 2) The area under the cumulative distribution curve starting from the percentage of blood pressure measurements within the range, and the percentage of values within symmetrically expanded boundary ranges, above and below the target range; 3) the slope of the cumulative distribution curve that is calculated by fitting an exponential cumulative distribution function and the natural logarithm of its rate parameter; 4) its x- and 5) y-axis intercepts; and 6) the fitting error. These outcome measures were validated using blood pressure measurements recorded during cardiovascular perturbation tests and prolonged monitoring period from individuals with chronic SCI and non-injured controls. The statistical analysis based on the effect size and intra-class correlation coefficient, demonstrated that the proposed outcome measures fulfill reliability, responsiveness and discrimination criteria. The novel methodology proposed in this study is reliable and effective for evaluating the stability of continuous blood pressure in individuals with chronic spinal cord injury.

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Intensive control of hypertension and risk of Alzheimer's dementia in older adults with depression

Yeung

Kiss

Gallagher

2020

Int J Geriat Psychiatry

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ObjectivesIntensive control of hypertension has been reported to decrease risk of cognitive decline. However, the effect of this in older adults with hypertension and comorbid depression is not well understood. We aim to identify whether intensive control of systolic blood pressure (BP) is associated with reduced risk of Alzheimer's dementia (AD) in a clinical population.MethodsUsing data from the National Alzheimer's Coordinating Center, we conducted survival analyses in older adults with normal cognition at baseline and treated hypertension. We also examined those with comorbid depression, to determine if intensive control of systolic BP (≤120 mmHg) was associated with reduced risk of AD.ResultsIn all older adults with treated hypertension (n = 4505), 298 (6.6%) developed AD during a median follow‐up duration of 4.2 years. In the comorbid depression subgroup (n = 1327), 152 (11.5%) developed AD. Intensive control of systolic BP was not significantly associated with reduced risk of AD in the overall sample (HR 1.13, 95%, 0.79‐1.64). However, in the comorbid depression subgroup, intensive control of systolic BP (≤120 mmHg) was associated with increased risk of AD (HR 1.49, 95%, 1.03‐2.15) compared to standard control (121‐139 mmHg).ConclusionsIn a clinical population of older adults with hypertension and comorbid depression, we found that an intensive systolic BP target of ≤120 mmHg was associated with increased risk of AD. While these findings are preliminary, they suggest that a more cautious approach to hypertension treatment may be warranted in this vulnerable subgroup.

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Orthostatic hypotension in patients with late‐life depression: Prevalence and validation of a new screening tool

Cited by 5 publications

References 39 publications

The Effects of Orthostatic Hypotension on Functional Status Parameters in Elderly and Very Elderly People

The Effects of Orthostatic Hypotension on Functional Status Parameters in Elderly and Very Elderly People

Novel Clinimetric Toolset to Quantify the Stability of Blood Pressure and Its Application to Evaluate Cardiovascular Function After Spinal Cord Injury

Intensive control of hypertension and risk of Alzheimer's dementia in older adults with depression

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