Science Journal of Clinical Medicine
Volume 7, Issue 4, July 2018, Pages: 30-36
Received: Sep. 4, 2018;
Accepted: Oct. 8, 2018;
Published: Nov. 6, 2018
Views 850 Downloads 99
Enwonwu Kenechukwu, Department of Community Medicine, NnamdiAzikiwe University Teaching Hospital, Nnewi, Nigeria
Ibeh Christian, Department of Community Medicine, NnamdiAzikiwe University Teaching Hospital, Nnewi, Nigeria
Modebe Ifeoma, Department of Community Medicine, NnamdiAzikiwe University Teaching Hospital, Nnewi, Nigeria
Owoaje Emeh, School of Public Health, University College Hospital, Ibadan, Nigeria
Ayuba Zoakah, Department of Community Medicine, University of Jos, Jos, Nigeria
Ifeadike Chigozie, Department of Community Medicine, NnamdiAzikiwe University Teaching Hospital, Nnewi, Nigeria
Ezeama Nkiru, Department of Community Medicine, NnamdiAzikiwe University Teaching Hospital, Nnewi, Nigeria
Azuike Emmanuel, Department of Community Medicine, NnamdiAzikiwe University Teaching Hospital, Nnewi, Nigeria
Background: Orthostatic hypotension is a condition in which blood pressure drops abnormally when a person stands up from a sitting or a lying down position. It is a sustained reduction of systolic blood pressure of at least 20mmHg or diastolic blood pressure of at least 10mmHg within three minutes of standing or a head-up tilt to at least 60 degrees on a tilt table. Orthostatic hypotension has been observed in all age groups, but it occurs more in the elderly, especially in persons who are sick and frail. The burden of Orthostatic hypotension on public health is substantial, with a prevalence of 7% to 55% in the elderly and is higher in those with risk factors. The diagnosis of orthostatic hypotension is therefore important in the treatment of elderly patients. Methods: This cross-sectional study was designed to evaluate the prevalence of orthostatic hypotension in community-dwelling elderly in Anambra State, Nigeria. The study population was a 400 persons aged 60 years and older selected by multistage sampling method. Results: The total prevalence of OH was 14.8% (n=59). The prevalence of OH was related to presence of hypertension, diabetes, raised supine systolic and raised supine diastolic BP (P ≤ 0.05). Diabetics [OR: 4.689 (95% CI: 1.121-19.984)] and those with supine diastolic hypertension [OR: 1.699 (95% CI: 0.401-7.209)] were more likely to have OH. Conclusion: The prevalence of orthostatic hypotension in 60 years and older adults in Anambra State was high and was found to be higher in hypertensives and diabetics.
Prevalence of Orthostatic Hypotension in the Elderly in Anambra State, Science Journal of Clinical Medicine.
Vol. 7, No. 4,
2018, pp. 30-36.
Enrique AL, Andrea AC, María de los Angeles C, Karla LC, Pablo ED. Prevalence of orthostatic hypotension in a series of elderly Mexican institutionalized patients. Cardiol J. 2011; 18 (3): 282-288.
Rutan GH, Hermanson B, Bild DE, Kittner SJ, LaBaw F, Tell GS. Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group. Hypertension. 1992; 19:508-19.
Judd E, Calhoun DA. Hypertension and orthostatic hypotension in older patients. J Hypertens (Los Angel). 2012; 30 (1):38-39.
Mader SL. Identification and Management of Orthostatic Hypotension in Older and Medically Complex Patients. Expert Rev CardiovascTher. 2012; 10 (3):387-395.
Avraham W, Ehud G, Yichayaou B, Joseph G. Orthostatic Hypotension in Acute Geriatric Ward. Is It a Consistent Finding? Arch Intern Med. 2002; 162 (20):2369-2374.
Baliga R, Prabhu G. Orthostatic hypotension in healthy elderly: Is it a myth? N Am J Med Sci. 2010; 2 (9):416-418.
Henricks M, Cutler M. Essential Facts About Orthostatic Hypotension. [Internet]. [Updated Sept 17 2015]. [Cited March 14 2016]. Available from:http//www.everydayhealth.com/news/essential-facts-about-orthostatic-hypotension.
Platts SH, Bairey CN, Barr Y, Qi F, Martha G, Hughson R. Effects of Sex and Gender on Adaptation to Space: Cardiovascular Alterations. Res J Womens Health 2014; 23 (11):950-955.
Weiss A, Beloosesky Y, Kornowski R, Yalov A, Grinblat J, Grossman E. Influence of Orthostatic Hypotension on Mortality Among Patients Discharged from an Acute Geriatric Ward. J Gen Intern Med. 2006; 21 (6):602-606.
Angelousi A, Girerd N, Benetos A. Association between orthostatic hypotension and cardiovascular risk, cerebrovascular risk, cognitive decline and falls as well as overall mortality: a systematic review and meta-analysis. J Hypertens 2014; 32:1562-1571.
Pepersack T, Gilles C, Petrovic M, Spinnewine A, Baeyens H, Beyer I et al. Prevalence of orthostatic hypotension and relationship with drug use amongst older patients. ActaClinBelg. 2013; 68 (2):107-12.
Hirai FE, Moss SE, Klein BEK, Klein R. Postural Blood Pressure Changes and Associated Factors in Long-Term Type 1 Diabetes: Wisconsin Epidemiologic Study of Diabetic Retinopathy. J Diabet Complications. 2009; 23 (2):83-88.
Aung, A K, Corcoran S J, Nagalingam V, Paul E, Newnham H H. Prevalence, Associations, and Risk Factors for Orthostatic Hypotension in Medical, Surgical, and Trauma Inpatients: An Observational Cohort Study. The Ochsner Journal. 2012; 12 (1): 35-41.
Sarasin FP, Louis-Simonet M, Carballo D, Slama S, Junod AF, Unger PF. Prevalence of orthostatic hypotension among patients presenting with syncope in the ED. Am J Emerg Med. 2002; 20 (6):497-501.
Wu J, Yang Y, Lu F, Wu C, Chang C. Population-based study on the prevalence and correlates of orthostatic hypotension/hypertension and orthostatic dizziness. Hypertens Res. 2008; 31 (5): 897-904.
Shin C, Abbott RD, Lee H, Kim J, Kimm K. Prevalence and correlates of orthostatic hypotension in middle-aged men and women in Korea: the Korean Health and Genome Study. J Hum Hypertens. 2004; 18: 717-723.
Mader SL, Josephson KR, Rubenstein LZ. Low Prevalence of Postural Hypotension Among Community-Dwelling Elderly. JAMA. 1987; 258 (11):1511-1514.
Weiss A, Beloosesky Y, Kornowski R, Yalov A, Grinblat J, Grossman E. Orthostatic hypotension in the elderly: are the diagnostic criteria adequate? J Hum Hypertens. 2004; 18:301–305.
Shibao C, Grijalva C, Raj SR, Biaggioni MS, Griffin M. Orthostatic Hypotension-Related Hospitalizations in the United States. Am J Med. 2007; 120:975-980.
Eze C, Onwuekwe I, Ogunniyi A. The frequency and pattern of cardiac autonomic neuropathy (CAN) in type 2 DM patients in a diabetic clinic in Enugu South-East Nigeria. Niger J Med 2013; 22:24-31.
Oduwole OA, Adeniyi OF, Esezebor CI, Ekure E, Fajolu IB, Renner JK. Postural hypotension in type 1 diabetes: The influence of glycemic control and duration of illness. Niger J ClinPract. 2014; 17 (2):140-144.
Eze CO1, Onwuekwe IO, Agu CE, Kalu UA. The prevalence of orthostatic hypotension in type 2 diabetes mellitus patients in a diabetic clinic in Enugu South-East Nigeria. Niger J Med. 2013; 22 (3):175-180.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, IzzoJr JL et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA. 2003; 289 (19):2560-2571.
Araoye MO. Research Methodology with Statistics for Health and Social Sciences: Sample size determination. Nathadex publishers. Nigeria. 2004. p. 115-120.
Hiitola P, Enlund H, Kettunen R, Sulkava R, Hartikainen S. Postural changes in blood pressure and the prevalence of orthostatic hypotension among home-dwelling elderly aged 75 years or older. J Hum Hypertens. 2009; 23:33–39.
Kamaruzzaman S, Watt H, Carson C, EbrahimS. The association between orthostatic hypotension and medication use in the British Women's Heart and Health Study. Age Ageing. 2010; 39: 51-56.
Fitzpatrick A, Theodorakis G, Vardas P. Methodology of head-up tilt testing in patients with unexplained syncope. J Am CollCardiol. 1991; 17 (1):125-30.
Tyberghein M, Philips JC, Krzesinski JM, ScheenAJ. Orthostatic hypotension: definition, symptoms, assessment and pathophysiology. Rev Med Liege. 2013; 68 (2):65-73.
Yu-Chien C, Aditi V, Hymen E, Perlmuter LC. Gender differences in orthostatic hypotension. Am J Med Sci. 2011; 342 (3): 221-225.
Carter III R, Hinojosa-Laborde C, Convertino VA. Sex comparisons in muscle sympathetic nerve activity and arterial pressure oscillations during progressive central hypovolemia. Physiological Reports.
Naschitz, JE, Slobodin G, Elias N, Rosner I. The patient with supine hypertension and orthostatic hypotension: a clinical dilemma. Postgrad Med J. 2006; 82 (966): 246-253.
Hosokawa K, Ide T, Tobushi T, Sakamoto K, Onitsuka K. Bionic Baroreceptor Corrects Postural Hypotension in Rats With Impaired Baroreceptor. Circulation. 2012; 126:1278-1285.
Gangavati A, Hajjar I, Quach L, Jones RN, Kiely DK, Gagnon P et al. Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. J Am Geriatr Soc. 2011; 59 (3):383-389.
Fedorowski A, Burri P, Melander O. Orthostatic hypotension in genetically related hypertensive and normotensive individuals. J Hypertens. 2009; 27 (5):976-82.
BâHamidou Oumar, MentaIchaka, SangaréIbrahima, SidibéNoumou, DiallIlo Bella, CoulibalySouleymane et al. Orthostatic Hypotension in a Population of Hypertensive Patients in the University Hospital Gabriel Touré. Clinical Medicine Research. 2015; 4 (4): 116-119.
Rahman S, Ahmad R, Aamir A H. Prevalence of orthostatic hypotension among diabetic patients in a community hospital of peshawar. Pak J Physiol. 2010; 6 (2):37-39.
Gaspara L, Kruzliakb P, Komornikovaa A, Celecovaa Z, Krahuleca B, Balaza D et al. Orthostatic hypotension in diabetic patients—10-year follow-up study. Journal of Diabetes and its Complications. 2016; 30 (1):67–71.
Tsutsu N, Nunoi K, Yokomizo Y, Kikuchi M, Fujishima M. Relationship between glycemic control and orthostatic hypotension in type 2 diabetes mellitus — A survey by the Fukuoka Diabetes Clinic Group. Diabetes Research and Clinical Practice. 1990; 8 (2):115-123.
El Bakkali1 M, Benjelloun H, Rkain H, Coghlan L, Radjab Y, Errguig L. A Cross-Sectional Study Evaluating Orthostatic Hypotension in Normotensive and Hypertensive Patients with Diabetes Mellitus. Journal of Cardiovascular Disease. 2013; 1 (1).