Orthostatic hypotension (OH) and mortality in relation to age, blood pressure and frailty

Michael R.H. Rockwood; Susan E. Howlett; Kenneth Rockwood

doi:10.1016/j.archger.2011.12.009

Orthostatic hypotension (OH) and mortality in relation to age, blood pressure and frailty

Michael R.H. Rockwood, Susan E. Howlett, Kenneth Rockwood

Research output: Contribution to journal › Article › peer-review

52 Citations (Scopus)

Abstract

Systolic hypertension and OH, as with many other deficits, accumulate with age. This deficit accumulation results in frailty: enhanced vulnerability to adverse outcomes. This study evaluated OH in relation to age, frailty, systolic hypertension, and mortality. In the population-based Canadian Study of Health and Aging second clinical examination, complete data were available on 1347 people, mean age = 83.3 (SD = 6.4). years. A frailty index (FI) was calculated from a 52-item Comprehensive Geriatric Assessment (CGA), yielding an FI-CGA from 0 (no deficits) to 1.0 (52 deficits). The mean change in blood pressure from lying to standing was 7.3 ± 15.6. mmHg (range +94 to -60). In total, 239 people (17.7%) had OH (change >20. mmHg systolic or >10. mmHg diastolic). Mean systolic blood pressure was higher (155.8 ± 23.3. mmHg) in people with OH than in those without (141.4 ± 23. mmHg), as was the FI-CGA (0.18 vs. 0.16). OH increased with frailty and systolic hypertension, but not age. Unadjusted, OH was associated with an increased risk of death (relative risk = 1.21, 95% confidence interval 1.19-1.23). Adjusted for frailty, this result was not significant. OH may be a marker of the system dysregulation seen in frailty, but as a state variable is a less powerful marker of vulnerability than is the FI-CGA.

Original language	English
Pages (from-to)	e255-e260
Journal	Archives of Gerontology and Geriatrics
Volume	54
Issue number	3
DOIs	https://doi.org/10.1016/j.archger.2011.12.009
Publication status	Published - May 2012

Bibliographical note

Funding Information:
The data reported in this article were collected as part of the CSHA. The core study was funded by the Seniors’ Independence Research Program, through the National Health Research and Development Program (NHRDP) Project 6606-3954-MC (S). Separate support for enriching the study of frailty in CSHA-2 came from NHRDP Project 6603-1417-302 (R). Funds for the present analysis came from the Fountain Innovation Fund of the Queen Elizabeth II Health Sciences Foundation and the Canadian Institutes of Health Research ( MOP-62823 ). KR is supported by the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research.

ASJC Scopus Subject Areas

Health(social science)
Ageing
Gerontology
Geriatrics and Gerontology

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10.1016/j.archger.2011.12.009

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title = "Orthostatic hypotension (OH) and mortality in relation to age, blood pressure and frailty",

abstract = "Systolic hypertension and OH, as with many other deficits, accumulate with age. This deficit accumulation results in frailty: enhanced vulnerability to adverse outcomes. This study evaluated OH in relation to age, frailty, systolic hypertension, and mortality. In the population-based Canadian Study of Health and Aging second clinical examination, complete data were available on 1347 people, mean age = 83.3 (SD = 6.4). years. A frailty index (FI) was calculated from a 52-item Comprehensive Geriatric Assessment (CGA), yielding an FI-CGA from 0 (no deficits) to 1.0 (52 deficits). The mean change in blood pressure from lying to standing was 7.3 ± 15.6. mmHg (range +94 to -60). In total, 239 people (17.7%) had OH (change >20. mmHg systolic or >10. mmHg diastolic). Mean systolic blood pressure was higher (155.8 ± 23.3. mmHg) in people with OH than in those without (141.4 ± 23. mmHg), as was the FI-CGA (0.18 vs. 0.16). OH increased with frailty and systolic hypertension, but not age. Unadjusted, OH was associated with an increased risk of death (relative risk = 1.21, 95% confidence interval 1.19-1.23). Adjusted for frailty, this result was not significant. OH may be a marker of the system dysregulation seen in frailty, but as a state variable is a less powerful marker of vulnerability than is the FI-CGA.",

author = "Rockwood, {Michael R.H.} and Howlett, {Susan E.} and Kenneth Rockwood",

note = "Funding Information: The data reported in this article were collected as part of the CSHA. The core study was funded by the Seniors{\textquoteright} Independence Research Program, through the National Health Research and Development Program (NHRDP) Project 6606-3954-MC (S). Separate support for enriching the study of frailty in CSHA-2 came from NHRDP Project 6603-1417-302 (R). Funds for the present analysis came from the Fountain Innovation Fund of the Queen Elizabeth II Health Sciences Foundation and the Canadian Institutes of Health Research ( MOP-62823 ). KR is supported by the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research. ",

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T1 - Orthostatic hypotension (OH) and mortality in relation to age, blood pressure and frailty

AU - Rockwood, Michael R.H.

AU - Howlett, Susan E.

AU - Rockwood, Kenneth

N1 - Funding Information: The data reported in this article were collected as part of the CSHA. The core study was funded by the Seniors’ Independence Research Program, through the National Health Research and Development Program (NHRDP) Project 6606-3954-MC (S). Separate support for enriching the study of frailty in CSHA-2 came from NHRDP Project 6603-1417-302 (R). Funds for the present analysis came from the Fountain Innovation Fund of the Queen Elizabeth II Health Sciences Foundation and the Canadian Institutes of Health Research ( MOP-62823 ). KR is supported by the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research.

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N2 - Systolic hypertension and OH, as with many other deficits, accumulate with age. This deficit accumulation results in frailty: enhanced vulnerability to adverse outcomes. This study evaluated OH in relation to age, frailty, systolic hypertension, and mortality. In the population-based Canadian Study of Health and Aging second clinical examination, complete data were available on 1347 people, mean age = 83.3 (SD = 6.4). years. A frailty index (FI) was calculated from a 52-item Comprehensive Geriatric Assessment (CGA), yielding an FI-CGA from 0 (no deficits) to 1.0 (52 deficits). The mean change in blood pressure from lying to standing was 7.3 ± 15.6. mmHg (range +94 to -60). In total, 239 people (17.7%) had OH (change >20. mmHg systolic or >10. mmHg diastolic). Mean systolic blood pressure was higher (155.8 ± 23.3. mmHg) in people with OH than in those without (141.4 ± 23. mmHg), as was the FI-CGA (0.18 vs. 0.16). OH increased with frailty and systolic hypertension, but not age. Unadjusted, OH was associated with an increased risk of death (relative risk = 1.21, 95% confidence interval 1.19-1.23). Adjusted for frailty, this result was not significant. OH may be a marker of the system dysregulation seen in frailty, but as a state variable is a less powerful marker of vulnerability than is the FI-CGA.

AB - Systolic hypertension and OH, as with many other deficits, accumulate with age. This deficit accumulation results in frailty: enhanced vulnerability to adverse outcomes. This study evaluated OH in relation to age, frailty, systolic hypertension, and mortality. In the population-based Canadian Study of Health and Aging second clinical examination, complete data were available on 1347 people, mean age = 83.3 (SD = 6.4). years. A frailty index (FI) was calculated from a 52-item Comprehensive Geriatric Assessment (CGA), yielding an FI-CGA from 0 (no deficits) to 1.0 (52 deficits). The mean change in blood pressure from lying to standing was 7.3 ± 15.6. mmHg (range +94 to -60). In total, 239 people (17.7%) had OH (change >20. mmHg systolic or >10. mmHg diastolic). Mean systolic blood pressure was higher (155.8 ± 23.3. mmHg) in people with OH than in those without (141.4 ± 23. mmHg), as was the FI-CGA (0.18 vs. 0.16). OH increased with frailty and systolic hypertension, but not age. Unadjusted, OH was associated with an increased risk of death (relative risk = 1.21, 95% confidence interval 1.19-1.23). Adjusted for frailty, this result was not significant. OH may be a marker of the system dysregulation seen in frailty, but as a state variable is a less powerful marker of vulnerability than is the FI-CGA.

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Orthostatic hypotension (OH) and mortality in relation to age, blood pressure and frailty

Abstract

Bibliographical note

ASJC Scopus Subject Areas

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