The association between orthostatic hypotension and medication use in the British Women's Heart and Health Study.
OBJECTIVE
to determine the prevalence of orthostatic hypotension (OH) and associations with medication use in community-dwelling older women.


METHODS
cross-sectional analysis using data from the British Women's Heart and Health Study.


METHODS
general practices in 23 towns in the UK.


METHODS
3,775 women aged 60-80 years from 1999 to 2001.


METHODS
orthostatic hypotension-drop of > or =20 mmHg in systolic and/or a drop of > or =10 mmHg in diastolic blood pressure on standing.


RESULTS
prevalence of OH was 28% (95% confidence interval [CI] 26.6, 29.4), which increased with age and hypertension. Regardless of treatment status or diagnosed hypertension, raised blood pressure was strongly associated with OH (P < 0.001). OH was strongly associated with number of antihypertensives taken (none vs three or more: odds ratio [OR] 2.24, 95% CI 1.47-3.40, P < 0.001); the association was slightly attenuated after allowing for age and co-morbidities (OR 1.99; 95% CI 1.30, 3.05; P = 0.003). Women with multiple co-morbidities had markedly increased odds of OH independent of age, number and type of medications taken (none vs four or more diagnoses: OR 2.28, 95% CI 1.58-3.30, P = 0.005).


CONCLUSIONS
uncontrolled hypertension, use of three or more antihypertensives and multiple co-morbidities are predictors of OH in older women. Detection or monitoring of OH in these groups may prevent women from suffering its adverse consequences.
Kamaruzzaman
Shahrul
S
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK. shahrul.kamaruzzaman@lshtm.ac.uk
Watt
Hilary
H
Carson
Claire
C
Ebrahim
Shah
S
D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors