Orthostatic Hypotension is a Risk Factor for Falls Among Older Adults: 3-Year Follow-Up

Abstract

Objectives: To assess the prevalence of orthostatic hypotension (OH) and the association of OH with the risk of falls among community-dwelling older adults with a previous fall. Design: Longitudinal study. Setting and Participants: The subjects (n ¼ 561) were participants in fall prevention conducted in western Finland. Methods: Blood pressure (BP) was measured in supine position and at 30 seconds and 3 minutes after standing. The participants were divided according to the consensus definition to an OH group (OHG) and a non-OH group (non-OHG). Falls were recorded by fall diaries during 12 months. Falls requiring treatment were gathered from health center and hospital registers during 12 and 36 months. Results: The prevalence of OH was 23.4% (30 seconds) and 7.3% (3 minutes). The 30-second measurement showed that the incidence of falls and that of falls requiring treatment were significantly higher in OHG compared with non-OHG during 12 months. After adjustments, the incidence of falls remained higher in all 5 adjusted models whereas that of falls requiring treatment remained higher only after adjustment for functional balance. The 3-minute measurement showed that the incidence of falls was higher in OHG compared with non-OHG during 12 months and remained higher after adjustments for functional balance and for age and functional balance. During the 36-month follow-up, OH measured at 30 seconds or 3 minutes after standing was not associated with the occurrence of falls leading to treatment. Conclusions and Implications: OH at 30 seconds or 3 minutes after standing is associated with a greater risk for falling within 12 months in older adults. The 30-second blood pressure measurement is more reliable to detect the risk than the 3-minute measurement. The results support the usability of 30-second measurement in determining OH and the risk for falling among older persons.

The prevalence and risk factors of orthostatic hypotension with cardiovascular diseases: An observational study

“…In this study, orthostatic hypotension was associated with the risk of falls, which is consistent with the ndings of most studies [44][45][46][47]. In orthostatic hypotension patients, blood accumulates in the lower extremities and internal organs after standing.…”

Prevalence of Cardiovascular Drugs and Oral Anticoagulant Use among Persons with and without Parkinson’s Disease

“…In persons with PD, the number of factors can be associated with weight loss, e.g., depression or depressive symptoms, loss of appetite, and nausea due to dopaminergic medications, and later on in sever stage, difficulties in chewing and swallowing, and impaired hand-mouth coordination [30]. Orthostatic hypotension, which is due to autonomic nervous system dysfunction in PD, can cause fatigue [31] and increases the risk of falls [32] and health care Babar/Kettunen/Tiihonen/Hartikainen/ Tolppanen utilization among persons with PD [33]. Most cardiovascular drugs induce or exacerbate orthostatic hypotension [34], which may explain the declining use of nitrates, thiazides, CCBs, β-blockers, ACEIs, and ARBs after PD diagnosis in our study.…”

Age as a risk factor for orthostatic hypotension induced by the levodopa challenge test in patients with Parkinson’s disease: Results from a single-center trial

“…Patients with OH are usually at a greater risk of falls and increased negative outcomes, including poor quality of life and mortality. [5,6]…”

“…Patients with OH are usually at a greater risk of falls and increased negative outcomes, including poor quality of life and mortality. [5,6] Levodopa (L-dopa) is a fundamental pharmacotherapy for management of PD symptoms. As the disease progresses, the effect of L-dopa on patient's BP should be closely monitored because anti-parkinsonian drugs, such as L-dopa, influence BP in patients with PD.…”