Please use this identifier to cite or link to this item: https://doi.org/10.1161/JAHA.119.014688
Title: Blood Pressure Drop Rate After Standing Up Is Associated With Frailty and Number of Falls in Geriatric Outpatients
Authors: Mol, Arjen
Slangen, Lois Robin Nicolle
Trappenburg, Marijke C
Reijnierse, Esmee M
van Wezel, Richard JA
Meskers, Carel GM
Maier, Andrea B 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
baroreflex
blood pressure
blood pressure measurement
monitoring
falls
frailty
geriatrics
orthostatic hypotension
ORTHOSTATIC HYPOTENSION
BAROREFLEX CONTROL
CARDIAC-OUTPUT
STATE
FLOW
Issue Date: 9-Apr-2020
Publisher: WILEY
Citation: Mol, Arjen, Slangen, Lois Robin Nicolle, Trappenburg, Marijke C, Reijnierse, Esmee M, van Wezel, Richard JA, Meskers, Carel GM, Maier, Andrea B (2020-04-09). Blood Pressure Drop Rate After Standing Up Is Associated With Frailty and Number of Falls in Geriatric Outpatients. JOURNAL OF THE AMERICAN HEART ASSOCIATION 9 (7). ScholarBank@NUS Repository. https://doi.org/10.1161/JAHA.119.014688
Abstract: BACKGROUND: The relationship between orthostatic hypotension and clinical outcome in older adults is poorly understood. Blood pressure drop rate (ie, speed of blood pressure drop) may particularly reflect the imposed challenge to the baroreflex and the associated clinical outcome (ie, frailty and number of falls). This study aimed to compare orthostatic blood pressure drop rate and drop magnitude with regard to their association with frailty and number of falls. METHODS AND RESULTS: Blood pressure was measured continuously during a standardized active stand task in 168 patients (mean age 81.4±7.0; 55.4% female) who visited a geriatric outpatient clinic for cognitive or mobility problems. The association of orthostatic blood pressure drop rate, blood pressure drop magnitude, and baroreflex sensitivity (ie, increase in heart rate divided by systolic blood pressure drop magnitude) with frailty (Fried criteria and 4 frailty markers) and self-reported number of falls was assessed using linear regression models, adjusting for age and sex. Systolic blood pressure drop rate had the strongest association with frailty according to the 4 frailty markers (β 0.30; 95% CI, 0.11–0.49; P=0.003) and number of falls (β 1.09; 95% CI, 0.19–1.20; P=0.018); diastolic blood pressure drop magnitude was most strongly associated with frailty according to the Fried criteria (β 0.37; 95% CI, 0.15–0.60; P<0.001). Baroreflex sensitivity was associated with neither frailty nor number of falls. CONCLUSIONS: Orthostatic blood pressure drop rate was associated with frailty and falls and may reflect the challenge to the baroreflex rather than drop magnitude.
Source Title: JOURNAL OF THE AMERICAN HEART ASSOCIATION
URI: https://scholarbank.nus.edu.sg/handle/10635/234919
ISSN: 2047-9980
DOI: 10.1161/JAHA.119.014688
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