Orthostatic hypotension and its associations with geriatric syndromes in subjects over 65 years old: data from EVKALIPT study

Q4 Medicine

Arterial Hypertension (Russian Federation) Pub Date : 2023-04-05 DOI:10.18705/1607-419x-2023-29-3-253-265

N. Vorobyeva, A. V. Luzina, I. Malaya, Y. Kotovskaya, O. Tkacheva

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Abstract

Objective. To estimate the prevalence of orthostatic hypotension (OH) and analyze its associations with geriatric syndromes (GS) in subjects aged ≥ 65 years.Design and methods. In total, 4308 subjects (30 % males) aged 65 to 107 years (mean age 78 ± 8 years) living in 11 regions of the Russian Federation were examined, who were divided into 3 age subgroups (65–74 years, 75–84 years and ≥ 85 years). All participants underwent a comprehensive geriatric assessment, which consisted of two stages: 1) questionnaire on a specially developed questionnaire; 2) objective examination. Orthostatic test was performed in 3982 (92,4 %) patients. OH was diagnosed with a decrease in systolic blood pressure (BP) by ≥ 20 mm Hg or diastolic BP — by ≥ 10 mm Hg (or a decrease in both parameters) within 3 minutes after switching to orthostasis.Results. The frequency of OH in all subjects was 7,9 %, including 6,7 % in subjects aged 65–74 years, 8,4 % — 75–84 years, 8,8 % — ≥ 85 years (p for trend = 0,093). Univariate regression analysis showed that with an age increase per every 1 year, the odds of OH increased by 1,4 % (odds ratio [OR] 1,014; 95 % confidence interval [CI] 1,001–1,028; p = 0,042). Univariate regression analysis also demonstrated that 5 of the 15 studied GSs were associated with the presence of OH: urinary (OR 1,41; 95 % CI 1,12–1,77; p = 0,004) and fecal (OR 1,61; 95 % CI 1,01–2,58; p = 0,046) incontinence, malnutrition (OR 1,77; 95 % CI 1,15–2,72; p = 0,009), visual deficit (OR 2,23; 95 % CI 1,47–3,40; p < 0,001) and falls in the previous year (OR 1,37; 95 % CI 1,08–1,75; p = 0,010). Multivariate regression analysis adjusted for age and sex found that only 2 GSs were independently associated with the presence of OH: urinary incontinence (OR 1,36; 95 % CI 1,08–1,72; p = 0,009) and visual deficit (OR 2,01; 95 % CI 1,37–3,19; p = 0,001).Conclusions. The EVKALIPT study first obtained domestic data on the prevalence of OH in subjects aged ≥ 65 years and studied the associations between OH and GSs.

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65岁以上受试者的体位性低血压及其与老年综合征的关系:来自EVKALIPT研究的数据

目标。在年龄≥65岁的受试者中，估计体位性低血压(OH)的患病率并分析其与老年综合征(GS)的关系。设计和方法。共纳入4308名年龄在65 ~ 107岁(平均年龄78±8岁)的俄罗斯联邦11个地区的受试者(30%为男性)，将其分为3个年龄亚组(65 ~ 74岁、75 ~ 84岁和≥85岁)。所有参与者都接受了全面的老年评估，该评估包括两个阶段:1)在专门开发的问卷上进行问卷调查;2)客观检查。3982例(92.4%)患者进行了直立试验。OH被诊断为收缩压(BP)下降≥20mm Hg或舒张压下降≥10mm Hg(或两项参数均下降)，在切换到正压矫正器后3分钟内。所有受试者中OH的发生率为7.9%，其中65 ~ 74岁为6.7%，75 ~ 84岁为8.4%，≥85岁为8.8%(趋势p = 0.093)。单因素回归分析显示，每1年年龄增加，OH的几率增加1.4%(比值比[OR] 1014;95%置信区间[CI] 1,001-1,028;P = 0.042)。单因素回归分析还表明，15例研究的GSs中有5例与OH的存在有关:尿(OR 1,41;95% ci 1,12 - 1,77;p = 0.004)和粪便(OR 1,61;95% ci 1,01 - 2,58;p = 0.046)尿失禁、营养不良(OR 1,77;95% ci 1,15 - 2,72;p = 0.009)，视力缺陷(OR 2,23;95% ci 1,47 - 3,40;p < 0.001)且上一年度下降(OR 1,37;95% ci 1,08 - 1,75;P = 0.010)。调整年龄和性别的多因素回归分析发现，只有2种GSs与OH的存在独立相关:尿失禁(OR 1,36;95% ci 1,08 - 1,72;p = 0.009)和视力缺陷(OR 2,01;95% ci 1,37 - 3,19;p = 0.001)。EVKALIPT研究首先获得了国内年龄≥65岁的OH患病率数据，并研究了OH与GSs之间的关系。

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来源期刊

Arterial Hypertension (Russian Federation) Medicine-Cardiology and Cardiovascular Medicine

CiteScore

0.90

自引率

0.00%

发文量

期刊介绍： The main aims of the Journal include collecting and generalizing the knowledge in hypertensiology; education and professional development of cardiologists and medical doctors of other specialties, who deal with different issues regarding diagnostics, management and prevention of hypertension in both clinical practice and research. The Journal also calls attention to the most urgent and up-to-date questions in hypertensiology, cardiology and related sciences. There are additional objectives, such as increasing the availability, accessibility and recognition of Russian medical scientific achievements at the international level by improving the quality of the publication and the way they are presented; enabling the exchange of opinions and information between scientists and their wider communication. The main criteria for publication selection fit with the mentioned objectives and include currency, singularity, scientific and practical novelty, applied relevance etc.