Prevalence of postural hypotension in patients with treated hypertension

Anna Grześkowiak, Agnieszka Rojek, Anna Szyndler, Katarzyna Śmiałek, Radosław Szczęch, Marzena Chrostowska, Krzysztof Narkiewicz

Abstract

Background The presence of hypertension, antihypertensive
therapy and elderly age are well known as common
causes of orthostatic hypotension. The aim of the study
was to evaluate the relationship between postural hypotension
and age, gender, BMI, visceral obesity and glucose
tolerance in hypertensive patients.

Material and methods
A total of 250 patients (125 females
and 125 males) with history of hypertension were recruited
for the study. The collected data included standing and
supine blood pressure measurements, glucose level, BMI
and waist circumference. The data were analyzed using
criteria of 20 mm Hg and 10 mm Hg SBP decreases in
response to standing.

Results
Mean blood pressure decrease did not depend on
age, sex, BMI, presence of visceral obesity or glucose level.
SBP pressure decrease of 10 mm Hg was more prevalent
in older (> 60 yrs) and obese (BMI > 30 kg/m2) patients.
There was a trend towards the correlation of 10 mm Hg
SBP decrease with visceral obesity and impaired glucose
levels. There were no other statistically significant correlation
between PH and investigated variables.

Conclusions
1. SBP decrease of 20 mm Hg is not sensitive
enough to diagnose postural hypotension among patients
with hypertension.
2. Prevalence of 10 mm Hg SBP decrease
in response to standing is related to age and BMI,
but not to visceral obesity or to blood glucose level.
3.
Prevalence of orthostatic hypotension in the present study
was less common than that suggested by earlier studies.
This might be attributed to more favorable farmacokinetic
profile of newer anti-hypertensive drugs.

Keywords

postural hypotension; orthostatic hypotension; hypertension; obesity; aging

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