title: Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study.
abstract: BACKGROUND
  Although orthostatic hypotension (OH) is more prevalent in old age, and in patients with diabetes, the prevalence of OH in older patients with type 2 diabetes mellitus is unknown.
  
  
  OBJECTIVE
  To establish the prevalence of OH, and its association with  falling, in home-dwelling older participants with and without type 2 diabetes.
  
  
  METHODS
  A cross-sectional study in primary care in the Netherlands.
  
  
  METHODS
  A total of 352 patients with type 2 diabetes, and 211 without participated in this study.  OH was defined as a fall in blood pressure of at least 20 mmHg systolic or 10 mmHg diastolic after either 1 or 3 minutes in an upright position. Feelings of dizziness, light-headedness, or faintness during the standing period were documented as orthostatic complaints. Fall risk was assessed  with a validated risk profile instrument.
  
  
  RESULTS
  The prevalence of OH was 28% (95% CI = 24% to 33%) and 18% (95% CI = 13% to 23%) in participants with and without type 2 diabetes, respectively. OH was not related to falling, while the presence of orthostatic complaints  in itself was associated with both previous fall incidents as well as a high fall risk, even after adjustment for OH. The adjusted odds ratios were 1.65 (95% CI = 1.00 to 2.72) and 8.21 (95% CI = 4.17 to 16.19), respectively.
  
  
  CONCLUSIONS
  OH is highly prevalent in home-dwelling  older people with and without type 2 diabetes. Those with orthostatic complaints had an increased risk for falling, whereas those with OH were not.
authors.affiliation: Diabetes Centre, Isala Clinics, Zwolle, The Netherlands. k.j.j.van.hateren@isala.nl
authors.forename: Kornelis J J
authors.initials: KJ
authors.lastname: van Hateren
authors.forename: Nanne
authors.initials: N
authors.lastname: Kleefstra
authors.forename: Marco H
authors.initials: MH
authors.lastname: Blanker
authors.forename: Lielith J
authors.initials: LJ
authors.lastname: Ubink-Veltmaat
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.forename: Sebastiaan T
authors.initials: ST
authors.lastname: Houweling
authors.forename: Adriaan M
authors.initials: AM
authors.lastname: Kamper
authors.forename: Klaas
authors.initials: K
authors.lastname: van der Meer
authors.forename: Henk J G
authors.initials: HJ
authors.lastname: Bilo
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D001795:Blood Pressure Determination; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000453:epidemiology* / Q000503:physiopathology; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors