title: Orthostatic Hypotension and Mortality in Elderly Frail Patients: A Retrospective Cross-Sectional Study.
abstract: Orthostatic hypotension (OH) is a common problem in the elderly age group, and some studies have reported an association between OH and increased mortality. We evaluated possible associations between OH and mortality in a retrospective study of frail elderly patients who came for a comprehensive geriatric assessment. The study included all patients ≥ 65 years who were assessed in the outpatient Comprehensive Geriatric Assessment Unit. Data were collected from the computerized medical record, including blood pressure, sociodemographic data, lifestyle, falls, pulse rate, body mass index, functional and cognitive status, and comorbidity. Data on mortality were also collected. The study population consisted of 571 patients who underwent assessment over a 9-year study period. The mean age was 83.7 ± 6.1, 35.9% were males, and 183 (32.1%) were diagnosed with OH. Systolic OH (OHS) was more common than diastolic OH (25.2% vs 15.6%). In univariate analyses, OHS was associated with increased overall mortality. Over the follow-up period, 30.2% of the OHS patients died compared with 22.3% (P = 0.037), but in the Cox models there was no statistically significant associations between OHS and overall mortality. In contrast, age, burden of comorbidity, a low high-density lipoprotein level, and low creatinine clearance were independent predictors of increased overall mortality. In a population of frail elderly patients with a high burden of comorbidity, OH was not an independent risk factor for overall mortality.
authors.affiliation: From the Department of Family Medicine (TF, BP, YP), Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev; Yasski Clinic (BP, YP), Comprehensive Geriatric Assessment Unit, Clalit Health Services; and Division of Health in the Community (BP, YP), Unit for Community Geriatrics, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Freud
authors.forename: Boris
authors.initials: B
authors.lastname: Punchik
authors.forename: Yan
authors.initials: Y
authors.lastname: Press
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015992:Body Mass Index; D003071:Cognition; D015897:Comorbidity; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D007024:Hypotension, Orthostatic / Q000453:epidemiology / Q000401:mortality*; D008019:Life Style; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors