[Orthostatic and postprandial hypotension in elderly patients with chronic diseases and disability: prevalence and related factors]. / Hipotensión ortostática e hipotensión posprandial en pacientes ancianos con discapacidad y enfermedades crónicas: prevalencia y factores relacionados.

INTRODUCTION: To assess the prevalence of orthostatic hypotension (OH) and postprandial hypotension (PPH) in patients admitted to an intermediate care unit, as well as to analyze the characteristics of these patients. PATIENTS AND METHODS: Sixty patients were analyzed according to the following criteria: age >65 years, able to take food orally, stand up and/or sit down, and clinically stable. A comprehensive geriatric assessment was carried out and the main diagnosis and the presence of autonomic neuropathy symptoms (ANS) were registered. Blood pressure (BP) was registered in the morning in supine position during the first 3min of postural change (standing or sitting). OH was defined as a decrease in systolic blood pressure (SBP) of 20mm Hg or a decrease in diastolic blood pressure (DBP) of 10mmHg. BP was registered after 15min of sitting and 60min after breakfast. PPH was defined as a decrease in SBP of 20mmHg. RESULTS: The mean age was 79.1+/-7.8 years. Nine patients (15%) had OH and 29 (48.3%) had PPH. The mean Lawton index (LI) score in patients with OH was 3.1+/-2.1 and was 5.2+/-2.6 in the remaining patients (P<.02). The mean body mass index (BMI) was 23.3+/-3.1 vs. 26.2+/-5.1 (P<.04). ANS was present in all nine patients (100%) with OH but in only 30 (58.8%) of the remaining 51 patients (chi-square=5.71; P<.03). CONCLUSIONS: PPH was more frequent than OH. Patients with OH had a significantly lower LI score and BMI. The presence of ANS was significantly more frequent in patients with OH. There was no significant relationship between HO and PPH or among the remaining variables studied.

Hipotensión ortostática e hipotensión posprandial en pacientes ancianos con discapacidad y enfermedades crónicas: prevalencia y factores relacionados / Orthostatic and postprandial hypotension in elderly patients with chronic diseases and disability: prevalence and related factors

Introducciónevaluar la prevalencia de hipotensión ortostática (HO) e hipotensión posprandial (HPP) en pacientes ingresados en una unidad de convalecencia y analizar sus características.Pacientes y métodosse analizó a 60 pacientes mayores de 65 años, con capacidad de ingesta por vía oral, de sedestación y/o bipedestación, y en situación de estabilidad clínica. Se realizó una valoración geriátrica completa y se registraron el diagnóstico principal y la presencia de síntomas de neuropatía autonómica (SNA). La presión arterial (PA) se registró por la mañana en posición supina y en los 3 primeros minutos de sedestación y/o bipedestación; se definió HO como el descenso de ≥20mmHg de PA sistólica (PAS) o ≥10mmHg de PA diastólica (PAD). Se registró también la PA después de que el paciente hubiera estado sentado 15min y 60min después del desayuno; se definió la HPP como el descenso de >20mmHg de la PAS.Resultadosla edad media±desviación estándar (DE) de los pacientes fue de 79,1±7,8 años. Nueve (15%) pacientes tuvieron HO y 29 (48,3%) HPP. La media±DE del índice de Lawton (IL) en pacientes con HO fue de 3,1±2,1; mientras que en los restantes fue de 5,2±2,6 (p<0,02) y la del índice de masa corporal (IMC) fue de 23,3±3,1 y 26,1±5,1 (p<0,04). Los 9 pacientes con HO tenían SNA (100%), mientras que de los 51 restantes sólo lo tuvieron 30 (58,8%) (χ2=5,71; p<0,03).Conclusionesla HPP fue más frecuente que la HO. Los pacientes con HO presentaron de forma significativa un menor IL e IMC. La presencia de SNA fue significativamente más frecuente en los pacientes con HO. No hubo relación significativa entre la HO y HPP, ni tampoco en el resto de las variables estudiadas (AU)

IntroductionTo assess the prevalence of orthostatic hypotension (OH) and postprandial hypotension (PPH) in patients admitted to an intermediate care unit, as well as to analyze the characteristics of these patients.Patients and methodsSixty patients were analyzed according to the following criteria: age >65 years, able to take food orally, stand up and/or sit down, and clinically stable. A comprehensive geriatric assessment was carried out and the main diagnosis and the presence of autonomic neuropathy symptoms (ANS) were registered. Blood pressure (BP) was registered in the morning in supine position during the first 3min of postural change (standing or sitting). OH was defined as a decrease in systolic blood pressure (SBP) of ≥20mm Hg or a decrease in diastolic blood pressure (DBP) of ≥10mmHg. BP was registered after 15min of sitting and 60min after breakfast. PPH was defined as a decrease in SBP of ≥20mmHg.ResultsThe mean age was 79.1±7.8 years. Nine patients (15%) had OH and 29 (48.3%) had PPH. The mean Lawton index (LI) score in patients with OH was 3.1±2.1 and was 5.2±2.6 in the remaining patients (P<.02). The mean body mass index (BMI) was 23.3±3.1 vs. 26.2±5.1 (P<.04). ANS was present in all nine patients (100%) with OH but in only 30 (58.8%) of the remaining 51 patients (chi-square=5.71; P<.03).ConclusionsPPH was more frequent than OH. Patients with OH had a significantly lower LI score and BMI. The presence of ANS was significantly more frequent in patients with OH. There was no significant relationship between HO and PPH or among the remaining variables studied (AU)