We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Orthostatic Hypotension in Middle-Age and Risk of Falls.
- Authors
Juraschek, Stephen P.; Daya, Natalie; Appel, Lawrence J.; Miller III, Edgar R.; Windham, Beverly Gwen; Pompeii, Lisa; Griswold, Michael E.; Kucharska-Newton, Anna; Selvin, Elizabeth
- Abstract
BACKGROUND: One-third of older adults fall each year. Orthostatic hypotension (OH) has been hypothesized as an important risk factor for falls, but findings from prior studies have been inconsistent. METHODS: We conducted a prospective study of the association between baseline OH (1987-1989) and risk of falls in the Atherosclerosis Risk in Communities (ARIC) Study. Falls were ascertained during follow-up via ICD-9 hospital discharge codes or Centers for Medicare & Medicaid Services claims data. OH was defined as a drop in systolic blood pressure (SBP) ≥20 mm Hg or diastolic blood pressure (DBP) =10 mm Hg within 2 minutes of moving from the supine to standing position. Changes in SBP or DBP during OH assessments were also examined as continuous variables. RESULTS: During a median follow-up of 23 years, there were 2,384 falls among 12,661 participants (mean age 54 years, 55% women, 26% black). OH was associated with risk of falls even after adjustment for demographic characteristics and other risk factors (hazard ratio (HR): 1.30; 95% confidence interval (CI): 1.10, 1.54; P = 0.002). Postural change in DBP was more significantly associated with risk of falls (HR 1.09 per -5 mm Hg change in DBP; 95% CI: 1.05, 1.13; P < 0.001) than postural change in SBP (HR 1.03 per -5 mm Hg change in SBP; 95% CI: 1.01, 1.05; P = 0.002). CONCLUSIONS: In a community-based, middle-aged population, OH, and in particular, postural change in DBP, were independent risk factors for falls over 2 decades of follow-up. Future studies are needed to examine OH thresholds associated with increased risk of falls.
- Subjects
ORTHOSTATIC hypotension; DIASTOLE (Cardiac cycle); REGULATION of blood pressure; RISK factors of falling down; SYSTOLIC blood pressure; EPIDEMIOLOGY
- Publication
American Journal of Hypertension, 2017, Vol 30, Issue 2, p188
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpw108