Factors associated with orthostatic hypotension in hospitalized elderly patients.
OBJECTIVE
To assess the factors associated with orthostatic hypotension (OH) in hospitalized elderly patients.


METHODS
Prospective observational single center study.


METHODS
A French academic center.


METHODS
One hundred and thirty-one patients without OH symptoms who underwent OH testing.


METHODS
The OH test was performed when the patient was able to get out of the bed and was no longer receiving parenteral fluids. The blood pressure was measured after a 10-min rest while the patients were sitting and then standing at 1 and 3 min. Demographic data, co-morbidities, current medications and biological parameters were recorded.


RESULTS
The mean patient age was 84.3 ± 7 years. The mean CIRS-G score was 10.6 ± 3.8. The OH test was performed 6.3 ± 3.9 days after admission and was positive in 39 (29.8 %) patients (95 % confidence interval (CI) 22, 38) and positive at 1 min in 87.2 % of the cases. Multivariate analysis showed that OH prevalence correlated with diabetes (odds ratio (OR) = 4.23; 95 % CI 1.10, 16.24; P = 0.03), serum 25-hydroxyvitamin D <20 ng/ml (OR = 3.38; 95 % CI 1.36, 8.42; P = 0.008), use of tranquilizers (anxiolytic and hypnotic) (OR = 2.96; 95 % CI 1.18, 7.4; P = 0.02), CIRS-G score (OR = 1.15; 95 % CI 1.01, 1.31; P = 0.03) and lack of diuretics (OR = 0.20; 95 % CI 0.06, 0.63; P = 0.005).


CONCLUSIONS
In older adults, OH is often misdiagnosed because it is asymptomatic. As practitioners may be reluctant to perform the OH test because of time constraints, targeting a subgroup of patients with a higher risk of OH should be worthwhile to prevent further OH complications.
Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France.
Aline
A
Guérin
Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France.
Marie-Laure
ML
Bureau
Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France.
Nisrin
N
Ghazali
Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France.
Raphaëlle
R
Gervais
Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France.
Evelyne
E
Liuu
Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France.
Florent
F
Seité
Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France. fabienne.bellarbre@chu-poitiers.fr.
Fabienne
F
Bellarbre
Pôle Biologie, Pharmacie et Santé Publique, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France.|INSERM, CIC-P 1402, Centre Hospitalier Universitaire de Poitiers, Poitiers, France.
Pierre
P
Ingrand
Pôle de Gériatrie, CHU La Milétrie, 86021, Poitiers Cedex, France. m.paccalin@chu-poitiers.fr.
Marc
M
Paccalin
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology*; D008297:Male; D011446:Prospective Studies
Diabetes; Elderly; Misdiagnosis; Orthostatic hypotension; Tranquilizers