Orthostatic hypotension: prevalence and associated risk factors among the ambulatory elderly in an Asian population

• Published in: Singapore medical journal 2016-08, Vol.57 (8), p.444-451
• Main Authors: Zhu, Qing Olivia, Tan, Choon Seng Gilbert, Tan, Hwee Leong, Wong, Ruining Geraldine, Joshi, Chinmaya Shrikant, Cuttilan, Ravi Amran, Sng, Gek Khim Judy, Tan, Ngiap Chuan
• Format: Article
• Language: English
• Subjects: Accidental Falls - prevention & control; Aged; Aged, 80 and over; Asian Continental Ancestry Group; Blood Pressure; Blood Pressure Determination; Cross-Sectional Studies; Female; Geriatrics; Humans; Hypotension, Orthostatic - diagnosis; Hypotension, Orthostatic - epidemiology; Hypotension, Orthostatic - therapy; Male; Middle Aged; Models, Statistical; Original; Prevalence; Primary Health Care; Risk Factors; Singapore
• ISSN: 0037-5675
• DOI: 10.11622/smedj.2016135

The prevalence of orthostatic hypotension (OH) among the elderly population in Singapore, as defined by a decline in blood pressure upon a change in position, is not well-established. Studies associate OH with clinically significant outcomes such as falls. This study aims to determine the prevalence of OH among elderly patients attending a public primary care clinic (polyclinic) for chronic disease management, and examine the relationships between postulated risk factors and OH. Patients aged ≥ 65 years attending a typical polyclinic in Geylang were identified and targeted for recruitment at the study site. A questionnaire on symptoms and postulated risk factors was administered, followed by supine and standing blood pressure measurements. Cross-sectional analysis was performed with independent sample t-test for continuous data and chi-square test for categorical data. Prevalence rate ratios with 95% confidence interval were calculated for the latter. A total of 364 multiethnic patients participated in the study. The prevalence of OH was 11.0%. Older age, comorbidities such as cardiac failure and kidney disease, being physically inactive at work, fatigue, self-reported dizziness in the past year, and the use of loop diuretics were found to be significantly associated with OH. About one in ten elderly patients at a local polyclinic was affected by OH, which was associated with multiple factors. Some of these factors are modifiable and can be addressed to reduce the incidence of OH.