HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Cited by other online articles Google Scholar Articles by Belmin, J. Articles by Marquet, T. Articles citing this Article PubMed PubMed Citation Articles by Belmin, J. Articles by Marquet, T.

Variability of Blood Pressure Response to Orthostatism and Reproducibility of the Diagnosis of Orthostatic Hypotension in Elderly Subjects

^a Department of Médecine Interne Gériatrique, Hôpital René Muret-Bigottini and University Paris-Nord, Sevran, France

Correspondence: Joël Belmin, Service de Médecine Interne Gériatrique, Hôpital René Muret-Bigottini and Université Paris-Nord, Avenue du Dr Schaëffner, 93270 Sevran, France E-mail: joel.belmin{at}rmb.ap-hop-paris.fr.

William B. Ershler, MD

Background.

Orthostatic hypotension (OH) is a major problem in the elderly population. Its diagnosis is based on measurement of the blood pressure (BP) response to orthostatism (BPRO). This study investigates the within-day and day-to-day variability of the BPRO and the reproducibility of the diagnosis of OH in this population.

Methods.

BP was measured in the supine position and after 1 and 2 minutes of orthostatism in 53 consecutive elderly patients (43 women and 10 men aged 83.7 ± 9.5 years) of an intermediate care geriatric ward. BPRO was assessed 4 times on the same day (8–9 AM, 10–11 AM, 1–2 PM, and 5–6 PM) and twice more on another day of the same week (8–9 AM and 1–2 PM).

Results

There were significant within-day differences between the four orthostatic changes in systolic BP (OCs, supine minus standing systolic BP) after 1 minute or 2 minutes (p < .05). Day-to-day differences between the OCs measured at the same times were not significant. OH defined as an OCs of 20 mm Hg or more at 1 or 2 minutes of orthostatism, was found in ten cases (19%) in the initial set of measurements on the first day. A cumulative diagnosis of OH after the six BPRO tests was found in 23 cases (43%). The reproducibility of the diagnosis of OH was mild or poor (all kappa values were below 0.47).

Conclusions.

BPRO exhibits significant within-day variability in elderly patients. Within-day and day-to-day reproducibility of the diagnosis of OH, based on conventional criteria, were found to be poor.

This article has been cited by other articles: (Search Google Scholar for Other Citing Articles)

				D. S. Goldstein, S. Pechnik, C. Holmes, B. Eldadah, and Y. Sharabi Association Between Supine Hypertension and Orthostatic Hypotension in Autonomic Failure Hypertension, August 1, 2003; 42(2): 136 - 142. [Abstract] [Full Text] [PDF]

				J. E. Morley Editorial: Postprandial Hypotension--The Ultimate Big Mac Attack J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2001; 56(12): M741 - 743. [Full Text] [PDF]