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

Journal article (2017)

Authors

E.S. de Bruijne Amstelland Hospital, Amsterdam UMC
E.M. Reijnierse Amsterdam UMC
M.C. Trappenburg Amstelland Hospital, Amsterdam UMC
J.H. Pasma Biomechatronics & Human-Machine Control - Mechanical, Maritime and Materials Engineering
Oscar J. De Vries OLVG Hospital
Carel G M Meskers Amsterdam UMC
Andrea B. Maier University of Melbourne, Vrije Universiteit Amsterdam
Research Group
Biomechatronics & Human-Machine Control (Mechanical, Maritime and Materials Engineering) (TU Delft)
Copyright: © 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
DOI
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https://doi.org/10.1159/000450642
Orthostatic hypotension Blood pressure Continuously measured blood pressure Older adults Stance Standing up slowly
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Published Date

2017

Language

English

Reuse Rights

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Faculty

Mechanical, Maritime and Materials Engineering

Department

Biomechanical Engineering

Research Group

Biomechatronics & Human-Machine Control

Abstract

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.