title: Orthostatic hypotension and orthostatic hypertension in American veterans.
abstract: OBJECTIVE
  Abnormal blood pressure (BP) response to orthostatic maneuvers may predict adverse health outcomes. Orthostatic hypotension (OH) is defined as a fall in BP of ≥20/10 mmHg, and orthostatic hypertension (OHTN) is defined as an increase in systolic BP (SBP) of ≥20 mmHg, with standing. Herein, we document the prevalence of OH and OHTN in American veterans.
  
  
  METHODS
  The influence of demographic characteristics, life habits, co-incident medical conditions, and prescription medication use on these prevalence rates and associations between abnormal orthostatic BP responses and severity of self-reported symptoms of fatigue, dizziness, trouble concentrating, and head and neck discomfort were determined.
  
  
  RESULTS
  286 veterans participated; 14 % were classified with OH, 22 % with OHTN, and 64 % with normal BP responses to standing (reference group). An increased prevalence of the diagnosis of diabetes mellitus (27 %) and hypertension (63 %) was noted, which did not differ by orthostatic BP classification. Veterans with OH were older than the reference group and were prescribed more antihypertensive medications than the reference and OHTN groups. While the prevalence of OH increased with age, the prevalence of OHTN was comparable in young (20-30 years) and old (70+ years) veterans (17 vs. 19 %, respectively). The severity of fatigue and dizziness was increased in veterans with OH and OHTN compared to the reference group.
  
  
  CONCLUSIONS
  These data suggest a relatively high prevalence of OH and OHTN, which is associated with increased self-reported severity of fatigue and dizziness in American veterans, findings which may adversely impact long-term health outcomes.
authors.affiliation: Center of Excellence, Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Rm. 7A-13, 130 West Kingsbridge Rd., Bronx, NY, 10468, USA. JM.Wecht@va.gov.|Department of Medicine, The Icahn School of Medicine Mount Sinai, New York, NY, USA. JM.Wecht@va.gov.|Department of Rehabilitation Medicine, The Icahn School of Medicine, Mount Sinai, New York, NY, USA. JM.Wecht@va.gov.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Wecht
authors.affiliation: Department of Health, Sport and Exercise Sciences, The University of Kansas, Lawrence, KS, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Weir
authors.affiliation: Center of Excellence, Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Rm. 7A-13, 130 West Kingsbridge Rd., Bronx, NY, 10468, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Martinez
authors.affiliation: Center of Excellence, Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Rm. 7A-13, 130 West Kingsbridge Rd., Bronx, NY, 10468, USA.
authors.forename: Mastanna
authors.initials: M
authors.lastname: Eraifej
authors.affiliation: Center of Excellence, Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Rm. 7A-13, 130 West Kingsbridge Rd., Bronx, NY, 10468, USA.|The Medical Service, James J. Peters VAMC, Bronx, NY, USA.|Department of Medicine, The Icahn School of Medicine Mount Sinai, New York, NY, USA.|Department of Rehabilitation Medicine, The Icahn School of Medicine, Mount Sinai, New York, NY, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Bauman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007024:Hypotension, Orthostatic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data
keywords: Age; American veterans; Orthostatic hypertension; Orthostatic hypotension; Prescription medications; Prevalence