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

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.