title: Uncontrolled hypertension and orthostatic hypotension in relation to standing balance in elderly hypertensive patients.
abstract: OBJECTIVE
  To investigate the associations among uncontrolled hypertension, orthostatic hypotension (OH), and standing balance impairment in the elderly hypertensive patients referred to comprehensive geriatric assessment (CGA).
  
  
  METHODS
  In a cross-sectional study, a total of 176 elderly hypertensive patients who underwent CGA were divided into OH group (n=36) and non-OH group (n=140) according to blood pressure measurement in the supine position, after immediate standing up, and after 1 minute and 3 minutes of standing position. Uncontrolled hypertension was defined as blood pressure of ≥140/90 mmHg if accompanied by diabetes mellitus (DM) or chronic kidney disease (CKD), or ≥150/90 mmHg if no DM and no CKD. Standing balance, including immediate standing balance and prolonged standing balance, was assessed in side-by-side and tandem stance.
  
  
  RESULTS
  Neither uncontrolled hypertension nor OH was associated with prolonged standing balance impairment in elderly hypertensive patients (P>0.05). Blood pressure decrease after postural change was significantly associated with immediate standing balance impairment in side-by-side and tandem stance (P<0.05). Patients with OH were at greater risk of immediate standing balance impairment in both side-by-side and tandem stance than those without OH (odds ratio [OR] 3.44, 95% confidence interval [CI] 1.26-9.33, P<0.05; OR 3.14, 95% CI 1.14-8.64, P<0.01). Furthermore, uncontrolled hypertension was associated with immediate standing balance impairment in side-by-side stance (OR 2.96, 95% CI 1.31-6.68, P<0.05).
  
  
  CONCLUSIONS
  Uncontrolled hypertension, OH, and blood pressure decrease after postural change were associated with immediate standing balance impairment, and therefore, a better understanding of the underlying associations might have major clinical value.
authors.affiliation: Department of Geriatrics, Zhejiang Hospital, Hangzhou, People's Republic of China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Shen
authors.affiliation: Department of Geriatrics, Zhejiang Hospital, Hangzhou, People's Republic of China.
authors.forename: Ting
authors.initials: T
authors.lastname: He
authors.affiliation: Department of Geriatrics, Zhejiang Hospital, Hangzhou, People's Republic of China.
authors.forename: Jiaojiao
authors.initials: J
authors.lastname: Chu
authors.affiliation: Department of Neurology, Fuyuan Hospital of Yiwu, Jinhua, People's Republic of China.
authors.forename: Jin
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Geriatrics, Zhejiang Hospital, Hangzhou, People's Republic of China.
authors.forename: Xujiao
authors.initials: X
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000145:classification / Q000627:therapeutic use; D001794:Blood Pressure; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D007024:Hypotension, Orthostatic / Q000503:physiopathology*; D008297:Male; D016017:Odds Ratio; D004856:Postural Balance / Q000502:physiology*; D011187:Posture / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents
keywords: balance; elderly; hypertension; orthostatic hypotension