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Orthostatic hypotension in the elderly: are the diagnostic criteria adequate?

Journal of Human Hypertension volume 18, pages 301–305 (2004)Cite this article

Abstract

Orthostatic hypotension (OH) is a common finding in the elderly. OH is defined as a fall of at least 20 mmHg in systolic blood pressure (BP) and/or 10 mmHg in diastolic BP upon assuming an upright posture. Some patients exhibit a fall in BP of less than the defined OH upon standing. The aim of this study was to estimate the prevalence of BP changes not defined as OH among elderly in-patients and to assess the relationship between these changes in the morning and the occurrence of OH during the day. Postural BP measurements were performed in 502 in-patients; in the morning, early afternoon, and in the evening. We defined intermediate postural drop (ID) in BP as a decrease of 10–19 mmHg in systolic BP and/or of 5–9 mmHg in diastolic BP. We observed that OH and ID occurred in 39.2 and 18.5% of the measurements in the morning, respectively. The prevalence of OH and ID was lower in the evening than in the morning (P<0.05) and afternoon (P<0.005). Postural BP changes in the morning correlated with those occurring later in the day. Patients who had ID in the morning had a 57% probability of having OH later during the day. In conclusions, ID is prevalent in elderly in-patients. ID in the morning predicts OH later in the day. Thus, postural BP drops below the OH range may be an important finding in the geriatric population.

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Acknowledgements

We thank Mrs Alexandra Yalov for the statistical analysis, Mrs Ruthy Miller, Mrs Gloria Ginzach and Mrs Doris Naor, for their helpful assistance in editing the manuscript and to Dr H Weiss, for her critical review of the paper.

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Authors and Affiliations

  1. Department of Geriatrics, Rabin Medical Center, Golda Campus, Petah Tiqwa

    A Weiss, Y Beloosesky & J Grinblat

  2. Department of Nephrology, Rabin Medical Center, Golda Campus, Petah Tiqwa

    A Chagnac & T Weinstein

  3. Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center Tel-Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    E Grossman

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  1. A Weiss
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  2. A Chagnac
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  3. Y Beloosesky
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  4. T Weinstein
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  6. E Grossman
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Correspondence to E Grossman.

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Weiss, A., Chagnac, A., Beloosesky, Y. et al. Orthostatic hypotension in the elderly: are the diagnostic criteria adequate?. J Hum Hypertens 18, 301–305 (2004). https://doi.org/10.1038/sj.jhh.1001668

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