Article

Prevalencia de hipotensión ortostática en ancianos hipertensos tratados en atención primaria

Atención Primaria (Impact Factor: 0.95). 01/2001; 28(3):151–157. DOI: 10.1016/S0212-6567(01)78924-X

ABSTRACT

Objective
To find the prevalence of orthostatic hypotension (OH) and associated factors in elderly hypertensive patients in a primary care setting.

Design
Descriptive cross-sectional study.

Setting
La Marina Health Centre (an urban centre in Santander).

Patients
A random sample of 295 patients aged 65 years or older regularly assisted from hypertension.

Measurements and main results
Measurements of sitting and standing blood pressure were obtained. Orthostatic hypotension was defined as 20 mmHg or greater decrease in systolic or 10 mmHg or greater decrease in diastolic blood pressure after 1-minute or 5-minute standing. Associated diseases, symptoms upon standing, medication use, habits and other clinical assessments were also recorded. The prevalence of OH was 14.6%. The prevalence of systolic OH after 1-minute (OH-S1) and after 5-minute (OH-S5) standing was 5.8% in both, and the diastolic OH was 5.1% after 1-minute (OH-D1) and 4.1% after 5-minute (OH-D5) standing. By logistic regression analysis, association between higher level of systolic blood pressure and global OH was found, also with the presence of orthostatic intolerance symptoms (although only 25.6% of the patients with OH showed symptoms) and smoking. Beta-blockers and calcium channel blockers (different from dihydropyridines) use was associated with OH after 1-minute standing and smoking with OH after 5-minute standing.

Conclusions
The detected prevalence is high and justifies the case finding of OH in elderly hypertensive patients in primary care. The symptoms of orthostatic intolerance are correlated with OH, but only 1 out of 4 patients showed symptoms. Smoking could be related with OH, so beta-blockers and calcium channel blockers (different from dihydropyridines) use.

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Available from: Pedro Munoz, Sep 24, 2015
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    ABSTRACT: CONCEPTO El Comité de Consenso de la Sociedad America-na de Enfermedades Autonómicas y de la Acade-mia Americana de Neurología definen la hipoten-sión ortostática (HO) como la caída de la presión arterial sistólica (PAS) mayor o igual a 20 milíme-tros de mercurio (mmHg) o de la presión arterial diastólica (PAD) mayor o igual a 10 mmHg que ocurre en los 3 minutos posteriores de pasar de la posición supina a la posición erguida. 1-5 Si bien ésta es la definición más aceptada, existe una gran disparidad de criterios entorno a este con-cepto. Hay autores que se basan únicamente en la PAS, dejando a un lado la PA D 6 . Otros reducen el tiempo de observación de 3 a 1 minuto 7 . Por último, hay autores que se apartan bastante de esta definición, utilizando los descensos de la presión arterial (PA) previa del paciente, bien en un 5% o más o en un 10% o más, al pasar del decúbito supino a la posición e rg u i d a 8 , también utilizan cualquier disminución de la PA que se acompañe de síntomas 9 , así como cual-quier PAS en bipedestación de menos de 95 mmHg 1 0 .
    Preview · Article · Nov 2002 · MEDIFAM - Revista de Medicina Familiar y Comunitaria

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