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OS 06-06 PREVALENCE AND CONSEQUENCE OF ORTHOSTATIC HYPERTENSION IN COMMUNITY DWELLING 85, AND 90 YEAR OLDS.
Journal of Hypertension 2016 September
OBJECTIVE: To investigate the prevalence, characteristics, and association with mortality of orthostatic hypertension (OHYPER) amongst the oldest old.
DESIGN AND METHOD: Two waves from the Jerusalem Longitudinal Study of community dwelling residents born in 1920-21 were examined at age of 85 (n = 1004), and 90 (n = 437). Sitting blood pressure (BP) was measured three times on two occasions, averaged and compared to 1 minute standing BP. OHYPER, orthostatic hypotension (OHYPO) or normotension (ONT) were classified if the difference of standing-sitting SBP either increased or decreased by ≥20mmHg, or not. Mortality data between ages 85-95 and 90-95 were collected from Ministry of Interior registry.
RESULTS: Prevalence of OHYPO, ONT, OHYPER was 4.8 % (n = 48), 91% (n = 915), and 4.1% (n = 41) at age 85, and 8.9% (n = 39), 88.1% (385), and 3.0% (n = 13) at age 90. There was a tendency for fewer men among OHYPER, and significantly more subjects with financial hardship, higher weight, loneliness, and anemia (p < 0.05 for all) among the 85 year olds, and fewer with poor self rated health, and more with anemia among the 90 year olds. Sitting SBP was 157 ± 22/75 ± 11, 147 ± 21/74 ± 11, and 140 ± 16/74 ± 10 mmHg among OHYPO, ONT, and OHYPER at age 85 (p < 0.0001), and 166 ± 28/75 ± 10, 145 ± 24/70 ± 11, and 136 ± 23/74 ± 9 mmHg at age 90 (p < 0.0001), respectively. Ten years survival was 27%, 30%, and 27% respectively at age 85 (log-rank p = 0.34). Five years survival was, 57%, 67%, and 55% respectively at age 90 (long-rank p = 0.14). In an adjusted Cox proportional Hazards Ratio model, OHYPER at age 85 was not associated with mortality (HR = 0.95, 95% confidence interval 0.65-1.39). Male gender, physical inactivity, anemia, activities of daily living dependence, diabetes, and ischemic heart disease were significant mortality predictors. The few OHYPER among 90 year olds precluded modeling.
CONCLUSIONS: OHYPER is quite uncommon among community dwelling 85 and 90 year olds, and unlike recent publications, is not associated with increased mortality.
DESIGN AND METHOD: Two waves from the Jerusalem Longitudinal Study of community dwelling residents born in 1920-21 were examined at age of 85 (n = 1004), and 90 (n = 437). Sitting blood pressure (BP) was measured three times on two occasions, averaged and compared to 1 minute standing BP. OHYPER, orthostatic hypotension (OHYPO) or normotension (ONT) were classified if the difference of standing-sitting SBP either increased or decreased by ≥20mmHg, or not. Mortality data between ages 85-95 and 90-95 were collected from Ministry of Interior registry.
RESULTS: Prevalence of OHYPO, ONT, OHYPER was 4.8 % (n = 48), 91% (n = 915), and 4.1% (n = 41) at age 85, and 8.9% (n = 39), 88.1% (385), and 3.0% (n = 13) at age 90. There was a tendency for fewer men among OHYPER, and significantly more subjects with financial hardship, higher weight, loneliness, and anemia (p < 0.05 for all) among the 85 year olds, and fewer with poor self rated health, and more with anemia among the 90 year olds. Sitting SBP was 157 ± 22/75 ± 11, 147 ± 21/74 ± 11, and 140 ± 16/74 ± 10 mmHg among OHYPO, ONT, and OHYPER at age 85 (p < 0.0001), and 166 ± 28/75 ± 10, 145 ± 24/70 ± 11, and 136 ± 23/74 ± 9 mmHg at age 90 (p < 0.0001), respectively. Ten years survival was 27%, 30%, and 27% respectively at age 85 (log-rank p = 0.34). Five years survival was, 57%, 67%, and 55% respectively at age 90 (long-rank p = 0.14). In an adjusted Cox proportional Hazards Ratio model, OHYPER at age 85 was not associated with mortality (HR = 0.95, 95% confidence interval 0.65-1.39). Male gender, physical inactivity, anemia, activities of daily living dependence, diabetes, and ischemic heart disease were significant mortality predictors. The few OHYPER among 90 year olds precluded modeling.
CONCLUSIONS: OHYPER is quite uncommon among community dwelling 85 and 90 year olds, and unlike recent publications, is not associated with increased mortality.
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