Heart rate, orthostatic test as markers of pathological aging

Abstract

Background. No increase or decrease in heart rate (HR) after transition to the upright position during orthostatic test is an important criterion for identifying older adults at risk of falls, but its relationship with other geriatric syndromes is unknown. Objective. To investigate the relationship between no increase or decrease of HR after transition to the upright position during orthostatic test and the prevalence of other geriatric syndromes.Design and methods. A cross-sectional cohort epidemiological study of EUCALYPTUS. Sample: random sample of community-dwelling older adults aged 65 years and older (n = 396). Methods: orthostatic test, analysis of medication therapy, comorbid chronic diseases, laboratory tests, comprehensive geriatric assessment.Results. No increase/ decrease in HR in the first minute after transition to the upright position during orthostatic test was associated with increased prevalence of frailty, as well as other geriatric syndromes, of which low level of physical function was the most significant. After adjusting for sex and age, atrial fibrillation, cognitive impairment, malnutrition, autonomy decline, and anemia, study participants with low physical function were 3,6 times more likely to find no increase or decrease in HR in the first minute after transition to the upright position during orthostatic test [odds ratio (95 % confidence interval) 3,620 (1,499 to 8,742)].Conclusions. The use of the marker “no increase/ decrease of HR in the first minute after transition to the upright position during” orthostatic test in older adults can serve as one of the important components of cardiovascular system reserve assessment and diagnosis of patients with decreased functional status and frailty.