Vitamin D deficiency is associated with orthostatic hypotension in oldest-old women.
OBJECTIVE
Orthostatic hypotension, a condition that mostly affects 'oldest-old' (i.e. ≥80 years) adults, is primarily explained by age-related dysfunction of blood pressure control. Vitamin D may contribute to blood pressure control. The aim of this study was to determine whether vitamin D deficiency is associated with orthostatic hypotension in oldest-old adults.


METHODS
Cross-sectional analysis at baseline of the EPIDOS study.


METHODS
Five French areas.


METHODS
A total of 329 community-dwelling oldest-old women (mean age 83.3 ± 0.2 years).


METHODS
Orthostatic hypotension was defined as a systolic blood pressure drop of ≥20 mmHg and/or a diastolic blood pressure drop of ≥10 mmHg within 3 min of standing. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25OHD) concentration ≤10 ng mL(-1) . Covariates included in the models were age, body mass index, diabetes mellitus, supine mean arterial pressure, number of drugs taken per day, use of antihypertensive or psychoactive drugs, cognition, quadriceps strength, current smoking, alcohol consumption, serum concentrations of parathyroid hormone, calcium and creatinine and season of testing.


RESULTS
Diastolic orthostatic hypotension was observed more often among women with vitamin D deficiency (19.2%) compared to those without (10.0%; P = 0.03). There was an inverse linear association between 25OHD concentration and change in diastolic blood pressure after 3 min of standing (adjusted β = -0.07, P = 0.046). Similarly, 25OHD deficiency was associated with orthostatic hypotension [adjusted odds ratio (OR) 3.36, P = 0.004], specifically with diastolic orthostatic hypotension (adjusted OR 3.81, P = 0.003).


CONCLUSIONS
25OHD deficiency was associated with orthostatic hypotension in oldest-old women, due to a greater drop in diastolic blood pressure on standing. This finding may lead to better understanding of the pathophysiology of falls in oldest-old adults with vitamin D deficiency.
Department of Geriatric Medicine, Angers University Hospital, Angers, France; UPRES EA4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, The University of Western Ontario, London, ON, Canada.
C
C
Annweiler
A-M
AM
Schott
Y
Y
Rolland
O
O
Beauchet
D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000503:physiopathology
D014807:Vitamin D; C104450:25-hydroxyvitamin D
older adults; orthostatic hypotension; vitamin D