Orthostatic hypotension (OH) and mortality in relation to age, blood pressure and frailty

作者：Rockwood Michael R H; Howlett Susan E; Rockwood Kenneth^*

来源：Archives of Gerontology and Geriatrics, 2012, 54(3): E255-E260.

DOI：10.1016/j.archger.2011.12.009

• Systolic hypertension
• Systolic blood pressure
• Diastolic blood pressure
• OH
• Deficit accumulation

Systolic hypertension and OH, as with many other deficits, accumulate with age. This deficit accumulation results in frailty: enhanced vulnerability to adverse outcomes. This study evaluated OH in relation to age, frailty, systolic hypertension, and mortality. In the population-based Canadian Study of Health and Aging second clinical examination, complete data were available on 1347 people, mean age = 83.3 (SD = 6.4) years. A frailty index (FI) was calculated from a 52-item Comprehensive Geriatric Assessment (CGA), yielding an FI-CGA from 0 (no deficits) to 1.0 (52 deficits). The mean change in blood pressure from lying to standing was 7.3 +/- 15.6 mmHg (range +94 to -60). In total, 239 people (17.7%) had OH (change %26gt;20 mmHg systolic or %26gt;10 mmHg diastolic). Mean systolic blood pressure was higher (155.8 +/- 23.3 mmHg) in people with OH than in those without (141.4 +/- 23 mmHg), as was the FI-CGA (0.18 vs. 0.16). OH increased with frailty and systolic hypertension, but not age. Unadjusted, OH was associated with an increased risk of death (relative risk = 1.21, 95% confidence interval 1.19-1.23). Adjusted for frailty, this result was not significant. OH may be a marker of the system dysregulation seen in frailty, but as a state variable is a less powerful marker of vulnerability than is the FI-CGA.

• 出版日期2012-6