title: Orthostatic hypotension: prevalence and associated risk factors among the ambulatory elderly in an Asian population.
abstract: BACKGROUND
  The prevalence of orthostatic hypotension (OH) among the elderly population in Singapore, as defined by a decline in blood pressure upon a change in position, is not well-established. Studies associate OH with clinically significant outcomes such as falls. This study aims to determine the prevalence of OH among elderly patients attending a public primary care clinic (polyclinic) for chronic disease management, and examine the relationships between postulated risk factors and OH.
  
  
  METHODS
  Patients aged ≥ 65 years attending a typical polyclinic in Geylang were identified and targeted for recruitment at the study site. A questionnaire on symptoms and postulated risk factors was administered, followed by supine and standing blood pressure measurements. Cross-sectional analysis was performed with independent sample t-test for continuous data and chi-square test for categorical data. Prevalence rate ratios with 95% confidence interval were calculated for the latter.
  
  
  RESULTS
  A total of 364 multiethnic patients participated in the study. The prevalence of OH was 11.0%. Older age, comorbidities such as cardiac failure and kidney disease, being physically inactive at work, fatigue, self-reported dizziness in the past year, and the use of loop diuretics were found to be significantly associated with OH.
  
  
  CONCLUSIONS
  About one in ten elderly patients at a local polyclinic was affected by OH, which was associated with multiple factors. Some of these factors are modifiable and can be addressed to reduce the incidence of OH.
authors.affiliation: MOH Holdings Private Limited, Singapore.
authors.forename: Qing Olivia
authors.initials: QO
authors.lastname: Zhu
authors.affiliation: Clinical and Corporate Services, Sing Health Polyclinics, Singapore.
authors.forename: Choon Seng Gilbert
authors.initials: CS
authors.lastname: Tan
authors.affiliation: MOH Holdings Private Limited, Singapore.
authors.forename: Hwee Leong
authors.initials: HL
authors.lastname: Tan
authors.affiliation: MOH Holdings Private Limited, Singapore.
authors.forename: Ruining Geraldine
authors.initials: RG
authors.lastname: Wong
authors.affiliation: MOH Holdings Private Limited, Singapore.
authors.forename: Chinmaya Shrikant
authors.initials: CS
authors.lastname: Joshi
authors.affiliation: MOH Holdings Private Limited, Singapore.
authors.forename: Ravi Amran
authors.initials: RA
authors.lastname: Cuttilan
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore.
authors.forename: Gek Khim Judy
authors.initials: GK
authors.lastname: Sng
authors.affiliation: Department of Research, Sing Health Polyclinics, Singapore.|Duke-NUS Medical School, Singapore.
authors.forename: Ngiap Chuan
authors.initials: NC
authors.lastname: Tan
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001794:Blood Pressure; D001795:Blood Pressure Determination; D003430:Cross-Sectional Studies; D005260:Female; D005853:Geriatrics; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D012846:Singapore
keywords: elderly; orthostatic hypotension; prevalence; primary care