Intraindividual variability in orthostatic blood pressure changes among older adults: the influence of meals - PubMed (original) (raw)
Intraindividual variability in orthostatic blood pressure changes among older adults: the influence of meals
F Puisieux et al. J Am Geriatr Soc. 1999 Nov.
Abstract
Objectives: To examine the influence of time of day and of meals on postural blood pressure (BP) changes in older adults.
Design: Prevalence study of BP changes in response to orthostasis.
Setting: A geriatric short-stay department
Participants: A total of 126 inpatients (91 women and 35 men; mean age: 81.4+/-7.9, range 61-95 years) were included in the study.
Measurements: Two sets of BP and heart rate measurements were obtained for each subject by one examiner using a standard mercury manometer: (1) in mid-morning (between 10:00 and 10:30 a.m.) and (2) within 30 to 60 minutes after lunch (between 1:00 and 1:30 p.m.). Orthostatic hypotension (OH) was defined as a systolic blood pressure (SBP) decline > or = 20 mm Hg within 3 minutes after standing.
Results: Sixty-one participants (48%) experienced significant orthostatic BP decline on at least one reading. Among them, 46 (37%) had OH in the mid-morning, and 32 (25%) had OH after lunch (P = .05). Only 17 (13%) had OH on both readings (persistent OH). Forty-four patients (35%) had variable OH. Patients with persistent OH were more likely to exhibit symptoms of dizziness and had a lower body mass index and a higher mean basal supine SBP. There was a positive correlation between basal supine SBP and postural SBP decline.
Conclusions: Because of the variability of postural BP changes, the diagnosis of OH should not be based on a single orthostatic BP measurement but requires repeated testing, at best under circumstances similar to those in which the symptoms occurred. The postprandial period is not particularly favorable to OH, suggesting that the ingestion of a meal does not worsen orthostatic BP changes in most aged patients.
Similar articles
- Postural blood pressure changes and orthostatic hypotension in the elderly patient: impact of antihypertensive medications.
Hajjar I. Hajjar I. Drugs Aging. 2005;22(1):55-68. doi: 10.2165/00002512-200522010-00004. Drugs Aging. 2005. PMID: 15663349 Review. - Patterns of orthostatic blood pressure change and their clinical correlates in a frail, elderly population.
Ooi WL, Barrett S, Hossain M, Kelley-Gagnon M, Lipsitz LA. Ooi WL, et al. JAMA. 1997 Apr 23-30;277(16):1299-304. JAMA. 1997. PMID: 9109468 - Orthostatic hypotension in acute geriatric ward: is it a consistent finding?
Weiss A, Grossman E, Beloosesky Y, Grinblat J. Weiss A, et al. Arch Intern Med. 2002 Nov 11;162(20):2369-74. doi: 10.1001/archinte.162.20.2369. Arch Intern Med. 2002. PMID: 12418952 - Intraindividual reproducibility of postprandial and orthostatic blood pressure changes in older nursing-home patients: relationship with chronic use of cardiovascular medications.
Jansen RW, Kelly-Gagnon MM, Lipsitz LA. Jansen RW, et al. J Am Geriatr Soc. 1996 Apr;44(4):383-9. doi: 10.1111/j.1532-5415.1996.tb06406.x. J Am Geriatr Soc. 1996. PMID: 8636581 Clinical Trial. - Prognosis of diastolic and systolic orthostatic hypotension in older persons.
Luukinen H, Koski K, Laippala P, Kivelä SL. Luukinen H, et al. Arch Intern Med. 1999 Feb 8;159(3):273-80. doi: 10.1001/archinte.159.3.273. Arch Intern Med. 1999. PMID: 9989539 Review.
Cited by
- Eight Orthostatic Haemodynamic Patterns in The Irish Longitudinal Study on Ageing (TILDA): Stability and Clinical Associations after 4 Years.
Moloney D, Knight SP, Newman L, Kenny RA, Romero-Ortuno R. Moloney D, et al. Geriatrics (Basel). 2021 May 11;6(2):50. doi: 10.3390/geriatrics6020050. Geriatrics (Basel). 2021. PMID: 34064800 Free PMC article. - Postural blood pressure changes and orthostatic hypotension in the elderly patient: impact of antihypertensive medications.
Hajjar I. Hajjar I. Drugs Aging. 2005;22(1):55-68. doi: 10.2165/00002512-200522010-00004. Drugs Aging. 2005. PMID: 15663349 Review. - Effect of Food Intake on Hemodynamic Parameters during the Tilt-Table Test in Patients with Postural Orthostatic Tachycardia Syndrome.
Habek M, Ruška B, Crnošija L, Adamec I, Junaković A, Krbot Skorić M. Habek M, et al. J Clin Neurol. 2019 Apr;15(2):205-210. doi: 10.3988/jcn.2019.15.2.205. Epub 2019 Mar 11. J Clin Neurol. 2019. PMID: 30877690 Free PMC article. - Contrasting effects of carbohydrate and water on blood pressure responses to postural maneuvers in patients with posturally related (vasovagal) syncope.
Pitt MS, Hainsworth R. Pitt MS, et al. Clin Auton Res. 2004 Aug;14(4):249-54. doi: 10.1007/s10286-004-0198-7. Clin Auton Res. 2004. PMID: 15316842 Clinical Trial. - The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension.
Gibbons CH, Schmidt P, Biaggioni I, Frazier-Mills C, Freeman R, Isaacson S, Karabin B, Kuritzky L, Lew M, Low P, Mehdirad A, Raj SR, Vernino S, Kaufmann H. Gibbons CH, et al. J Neurol. 2017 Aug;264(8):1567-1582. doi: 10.1007/s00415-016-8375-x. Epub 2017 Jan 3. J Neurol. 2017. PMID: 28050656 Free PMC article. Review.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical