title: Age-related normative changes in phasic orthostatic blood pressure in a large population study: findings from The Irish Longitudinal Study on Ageing (TILDA).
abstract: BACKGROUND
  In this report, we provide the first normative reference data and prevalence estimates of impaired orthostatic blood pressure (BP) stabilization, initial orthostatic hypotension, and orthostatic hypotension based on beat-to-beat blood pressure methods in a population-representative sample.
  
  
  RESULTS
  Participants were recruited from a nationally representative cohort study (≥50 years). Beat-to-beat systolic BP, diastolic BP, and heart rate records were analyzed among those who underwent an active stand test (n=4475). Normograms were estimated by use of generalized additive models for location, shape, and scale with Box-Cox power exponential distribution. Prevalence estimates of impaired BP stabilization, initial orthostatic hypotension, and orthostatic hypotension are reported. Orthostatic BP responses in adults aged 50 to 59 years stabilized within 30 seconds of standing, with older groups taking 30 seconds or longer. The total prevalence of impaired BP stabilization was 15.6% (95% confidence interval [CI], 14.1%-17.1%), increasing with age to 41.2% (95% CI, 30.0%-52.4%) in people ≥80 years old. Initial orthostatic hypotension occurred in 32.9% (95% CI, 31.2%-34.6%) of the population aged ≥50 years, with no age gradient evident. The prevalence of orthostatic hypotension was 6.9% (95% CI, 5.9%-7.8%) in the total population, increasing to 18.5% (95% CI, 9.0%-28.0%) in those aged ≥80 years old.
  
  
  CONCLUSIONS
  Significant age-related differences exist in the time course of postural BP responses, with abnormal responses taking longer than 30 seconds to stabilize. Impaired BP stabilization is more common as we age, affecting more than two-fifths of the population aged ≥80 years, and may play a future role in the management of falls and syncope.
authors.affiliation: From The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland (C.F., M.D.L. O., H.N., H.C., R.A.K.); Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland (C.F., C.J.S.); Department of Medical Gerontology, Mater Hospital, Dublin, Ireland (C.W.F.); and School of Health Sciences, University of East Anglia, Norwich, United Kingdom (G.M.S.). cfinucane@stjames.ie.
authors.forename: Ciarán
authors.initials: C
authors.lastname: Finucane
authors.affiliation: From The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland (C.F., M.D.L. O., H.N., H.C., R.A.K.); Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland (C.F., C.J.S.); Department of Medical Gerontology, Mater Hospital, Dublin, Ireland (C.W.F.); and School of Health Sciences, University of East Anglia, Norwich, United Kingdom (G.M.S.).
authors.forename: Matthew D L
authors.initials: MD
authors.lastname: O'Connell
authors.affiliation: From The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland (C.F., M.D.L. O., H.N., H.C., R.A.K.); Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland (C.F., C.J.S.); Department of Medical Gerontology, Mater Hospital, Dublin, Ireland (C.W.F.); and School of Health Sciences, University of East Anglia, Norwich, United Kingdom (G.M.S.).
authors.forename: Chie Wei
authors.initials: CW
authors.lastname: Fan
authors.affiliation: From The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland (C.F., M.D.L. O., H.N., H.C., R.A.K.); Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland (C.F., C.J.S.); Department of Medical Gerontology, Mater Hospital, Dublin, Ireland (C.W.F.); and School of Health Sciences, University of East Anglia, Norwich, United Kingdom (G.M.S.).
authors.forename: George M
authors.initials: GM
authors.lastname: Savva
authors.affiliation: From The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland (C.F., M.D.L. O., H.N., H.C., R.A.K.); Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland (C.F., C.J.S.); Department of Medical Gerontology, Mater Hospital, Dublin, Ireland (C.W.F.); and School of Health Sciences, University of East Anglia, Norwich, United Kingdom (G.M.S.).
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Soraghan
authors.affiliation: From The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland (C.F., M.D.L. O., H.N., H.C., R.A.K.); Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland (C.F., C.J.S.); Department of Medical Gerontology, Mater Hospital, Dublin, Ireland (C.W.F.); and School of Health Sciences, University of East Anglia, Norwich, United Kingdom (G.M.S.).
authors.forename: Hugh
authors.initials: H
authors.lastname: Nolan
authors.affiliation: From The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland (C.F., M.D.L. O., H.N., H.C., R.A.K.); Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland (C.F., C.J.S.); Department of Medical Gerontology, Mater Hospital, Dublin, Ireland (C.W.F.); and School of Health Sciences, University of East Anglia, Norwich, United Kingdom (G.M.S.).
authors.forename: Hilary
authors.initials: H
authors.lastname: Cronin
authors.affiliation: From The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland (C.F., M.D.L. O., H.N., H.C., R.A.K.); Department of Medical Physics and Bioengineering, St. James's Hospital, Dublin, Ireland (C.F., C.J.S.); Department of Medical Gerontology, Mater Hospital, Dublin, Ireland (C.W.F.); and School of Health Sciences, University of East Anglia, Norwich, United Kingdom (G.M.S.).
authors.forename: Rose Anne
authors.initials: RA
authors.lastname: Kenny
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001794:Blood Pressure; D003971:Diastole; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000453:epidemiology* / Q000503:physiopathology; D007494:Ireland; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011187:Posture; D015995:Prevalence; D012016:Reference Values; D013599:Systole; D013997:Time Factors
keywords: epidemiology; hypotension, orthostatic; syncope