[Orthostatic and postprandial hypotension in patients aged 70 years or older admitted to a medical ward]

Abstract

The aim of this study was to determine the prevalence of orthostatic (OH) and postprandial hypotension (PPH) in Dutch elderly patients admitted to a medical ward and to explore patient characteristics associated with OH and PPH: symptoms, medications and comorbidity. We studied 50 patients, mean age 78.8 years, 68% female. Orthostatic hypotension (OH) was defined as a decrease of systolic blood pressure (BP) > or = 20 or diastolic > or = 10 mm Hg after 3 minutes of standing. To diagnose postprandial hypotension (PPH) BP was measured sitting before and 30 minutes after the start of patient's noon meal, the same criteria were applied. We registered changes in BP, pulse rate, complaints, reason for hospitalization, medication and comorbidity: hypertension, diabetes mellitus and Parkinson(ism). We found OH in 24% of the patients, PPH was diagnosed more frequently: in 34%. 10% had both, but there were no relations between OH and PPH. In none of the patients OH and PPH were measured before our assessment. Pulse rate increased respectively 8 and 3/min. With OH and PPH. Both subjective and objective complaints were significantly associated with OH, where as only subjective non-specific complaints were associated with PPH. Objective complaints were very rare in PPH. OH and PPH were not significantly associated with medication use and comorbidity. PPH and OH are common in hospitalized elderly patients. OH is more often symptomatic than PPH. We found no relationship with medication use or comorbidity. According to research literature, however, OH and PPH are associated with higher morbidity, mortality and possibly cognitive decline. Therapeutic measures must be considered, especially in the presence of comorbidity such as significant carotid artery occlusion.