Arterial stiffness is associated with orthostatic hypotension in elderly subjects with history of falls.
OBJECTIVE
To test the hypothesis that impaired hemodynamic orthostatic changes commonly observed in the elderly may be related to age-related increase in arterial wall stiffness.


METHODS
Convenience sample of consecutive patients admitted for falls.


METHODS
Acute- and intermediate-care geriatric ward of a French hospital.


METHODS
Fifty-seven elderly patients (46 women) consecutively admitted to a geriatric ward with a history of recent falls.


METHODS
Orthostatic hypotension (OH) was assessed using blood pressure measurements in the supine position and 1, 2, and 3 minutes after standing. Arterial wall stiffness was assessed using upper-limb and aortic pulse-wave velocities, measured with an external pressure transducer connected to a computer.


RESULTS
OH was present in 18 patients with a mean age+/-standard deviation of 85.4+/-7.6 (5 men, 13 women) and absent in 39 patients aged 83.7+/-6.2 (6 men, 33 women). Upper-limb pulse-wave velocity was significantly higher, by 16%, in patients with OH than those without (9.91 vs 8.53 m/s; P<.02). Significant correlations were found between upper-limb pulse-wave velocity and systolic blood pressure changes after 1 minute of standing (r=0.263, P<.05) and maximal diastolic blood pressure change after standing (r=0.351, P<.01).


CONCLUSIONS
Upper-limb arterial wall stiffness was significantly greater in elderly patients with OH than in patients without OH and was significantly related to blood pressure changes after standing. These results highlight the possible role of age-related changes in the arterial tree in the hemodynamic response to orthostatic challenges.
Boddaert
Jacques
J
Service de Médecine Interne Gériatrique, Hôpital Charles Foix et Université Paris 61, Ivry-sur-Seine, France.
Tamim
Hani
H
Verny
Marc
M
Belmin
Joël
J
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology; D001132:Arm / Q000098:blood supply; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D016022:Case-Control Studies; D003971:Diastole; D004548:Elasticity; D005260:Female; D005602:France; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D013599:Systole; D014463:Ultrasonography