The association between orthostatic hypertension and all-cause mortality in hospitalized elderly persons.
BACKGROUND
Little is known about the prevalence of orthostatic hypertension (OHT) and its effect on long-term mortality in the elderly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized elderly patients.


METHODS
Out of 1852 patients admitted between 31/12/1999 and 31/12/2000 to an acute geriatric ward, 474 patients (48% males) with a mean age of 81.5 ± 6.8 years were enrolled in this study. Blood pressure (BP) was measured three times during the day in a supine and standing position. Patients with at least one increase in systolic or diastolic BP levels upon standing were diagnosed with OHT. Medical history, physical examination and laboratory parameters were retrieved from the medical records. Mortality data until 18(th) June 2014 were retrieved from the computerized system of the Ministry of the Interior.


RESULTS
Four hundred and seven patients (86%) were diagnosed with OHT. Those without OHT had a lower body mass index and were more likely males, smokers, had a higher rate of Parkinson's disease and less congestive heart failure compared with those with OHT. Patients with OHT had a better survival rate than those without OHT (P = 0.024). Hazard ratios (HRs) for mortality in those with OHT adjusted to age and multiple risk factors were: 0.67 [95% confidence interval (CI): 0.51-0.87] and 0.73 (95% CI: 0.55-0.97), respectively; a similar tendency was noticed in a sensitivity analysis by gender.


CONCLUSIONS
Hospitalized elderly patients with OHT had a better survival rate than those without OHT.
Department of Geriatrics, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
Avraham
A
Weiss
Department of Geriatrics, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
Yichayaou
Y
Beloosesky
Sackler Faculty of Medicine, Tel Aviv University, Israel; Department of Internal Medicine E, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel.
Alon
A
Grossman
Department of Geriatrics, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
Agata
A
Shlesinger
Sackler Faculty of Medicine, Tel Aviv University, Israel; Department of Epidemiology and Preventive Medicine, Tel Aviv University, Israel.
Nira
N
Koren-Morag
Sackler Faculty of Medicine, Tel Aviv University, Israel; Internal Medicine Department and Hypertension Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Ehud
E
Grossman
Hypertension; Mortality; Orthostatic; The elderly