Standing up slowly antagonises initial blood pressure decrease in older adults with orthostatic hypotension

Standing up slowly antagonises initial blood pressure decrease in older adults with orthostatic hypotension

de Bruijne, E.S. (Amsterdam UMC; Amstelland Hospital)
Reijnierse, E.M. (Amsterdam UMC)
Trappenburg, M.C. (Amsterdam UMC; Amstelland Hospital)
Pasma, J.H. (TU Delft Biomechatronics & Human-Machine Control)
De Vries, Oscar J. (OLVG Hospital)
Meskers, Carel G M (Amsterdam UMC)
Maier, Andrea B. (University of Melbourne; Vrije Universiteit Amsterdam)

2017

Background: Orthostatic hypotension (OH) is common in older adults and associated with increased morbidity and mortality, loss of independence and high health-care costs. Standing up slowly is a recommended non-pharmacological intervention. However, the effectiveness of this advice has not been well studied. Objectives: The aim of this study was to investigate whether standing up slowly antagonises posture-related blood pressure (BP) decrease in a clinically relevant population of geriatric outpatients. Methods: In this cross-sectional study, 24 community-dwelling older adults referred to a geriatric outpatient clinic and diagnosed with OH were included. BP was measured continuously during 3 consecutive transitions from supine to standing position during normal, slow and fast transition. Results: The relative BP decrease at 0-15 s after slow transition was significantly lower than after normal transition (p = 0.003 for both systolic BP and diastolic BP) and fast transition (p = 0.045 for systolic BP; diastolic BP: non-significant). The relative diastolic BP decrease at 60-180 s after normal transition was significantly lower than after fast transition (p = 0.029). Conclusion: Standing up slowly antagonises BP decrease predominantly during the first 15 s of standing up in a clinically relevant population of geriatric outpatients diagnosed with OH. Results support the non-pharmacological intervention in clinical practice to counteract OH.

Blood pressure
Continuously measured blood pressure
Older adults
Orthostatic hypotension
Stance
Standing up slowly

http://resolver.tudelft.nl/uuid:6953bba6-2b76-4d42-b4b1-e0c9c237b739

https://doi.org/10.1159/000450642

2017-10-19

0304-324X

Gerontology: international journal of experimental, clinical, behavioral, regenerative and technical gerontology, 63 (2), 137-143

Accepted Author Manuscript

Institutional Repository

journal article

© 2017 E.S. de Bruijne, E.M. Reijnierse, M.C. Trappenburg, J.H. Pasma, Oscar J. De Vries, Carel G M Meskers, Andrea B. Maier