title: Tilting-induced decrease in systolic blood pressure in bedridden hypertensive elderly inpatients: effects of azelnidipine.
abstract: The object of this study was to examine blood pressure (BP) variability due to postural change in elderly hypertensive patients. The subjects studied were 154 elderly inpatients in a hospital for the elderly (48 male and 106 female; median age: 82 years), consisting of age- and sex-matched bedridden (n=39) and non-bedridden (n=39) normotensive controls and bedridden (n=38) and non-bedridden (n=38) hypertensive patients. BP and pulse rate (PR) were measured in the supine position, then again after a 2-min, 45 deg head-up tilt with the legs horizontal. The decrease in systolic BP (SBP) on tilting in the bedridden hypertensive group (median: -10 mmHg; range: -32 to 9 mmHg) was significantly (p<0.008) greater than those in the other three groups. Monotherapy with azeinidipine, a long-acting calcium channel blocker, for 3 months not only significantly reduced the basal BP and PR of hypertensive patients in the two groups, but also significantly (p<0.05) attenuated the tilt-induced decrease in the SBP to -3 mmHg (-19 to 25 mmHg) and enhanced the change in PR from -1 bpm (-10 to 7 bpm) to 1 bpm (-4 to 23 bpm) in the bedridden hypertensive group. Our findings indicate that tilt-induced decrease in SBP is a rather common phenomenon in bedridden elderly hypertensive patients, and that treatment with azelnidipine attenuates tilt-induced decrease in SBP, probably through an improvement of baroreceptor sensitivity.
authors: Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan. shigeto@kanazawa-med.ac.jp
authors: Shigeto
authors: S
authors: Morimoto
authors: Takashi
authors: T
authors: Takahashi
authors: Kohya
authors: K
authors: Okaishi
authors: Takeshi
authors: T
authors: Nakahashi
authors: Kohji
authors: K
authors: Nomura
authors: Tsugiyasu
authors: T
authors: Kanda
authors: Masashi
authors: M
authors: Okuro
authors: Hiroshi
authors: H
authors: Murai
authors: Tomoichi
authors: T
authors: Nishino
authors: Masayuki
authors: M
authors: Matsumoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001383:Azetidinecarboxylic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007297:Inpatients; D008297:Male; D011187:Posture; D013599:Systole
chemical_list: D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D001383:Azetidinecarboxylic Acid; C061679:azelnidipine