Hypertension. 2024;81(6):1383-1390.
Association Between Orthostatic Hypertension and Frailty Among Older Patients With Hypertension.
제1저자 최정연, 류동열 · 교신저자 김광일
소속 (17)
- Departmentof Internal Medicine, Seoul National University Bundang Hospital, Seongnam (J.-Y.C., C.-H.K., K.-I.K.).
- Division of Cardiology, Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon (D.R.R.).
- Department of Internal Medicine (H.-Y.L., S.-H.K., H.-L.K., K.-i.K.), Seoul National University College of Medicine.
- Department of Internal Medicine, Seoul National University Hospital (H.-Y.L.).
- Departmentof Internal Medicine, Chungbuk National University College of Medicine, Cheongju (J.-H.L., M.-C.C.).
- Department of Preventive Medicine (Y.H., S.K.P.), Seoul National University College of Medicine.
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Korea (Y.H., S.K.P.), Seoul National University College of Medicine.
- Cancer Research Institute, Seoul National University (Y.H., S.K.P.).
- Department of Cardiology and Cardiocerebrovascular Center, Chungbuk National University Hospital, Cheongju (J.-H.L., M.-C.C.).
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu (J.H.L.).
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju (S.-J.H.).
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju (K.H.K.).
- Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju (S.H.L.).
- Division of Cardiology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju (S.Y.K.).
- Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon (J.-H.P.).
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Korea (S.-H.K., H.-L.K.).
- Division of Cardiology, Department of Internal Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea (J.H.C.).
Abstract
BACKGROUND Frailty frequently coexists with hypertension in older patients. We aimed to evaluate the association between frailty and positional change in blood pressure, especially orthostatic hypertension.
METHODS Participants were recruited from 12 University hospitals in South Korea. Using a digital device, trained research nurses measured blood pressure in the supine and standing positions. Physical frailty was evaluated using the Korean version of the FRAIL questionnaire, gait speed, and handgrip strength. Orthostatic hypertension was defined as a ≥20-mm Hg increase in systolic blood pressure within 3 minutes of standing and upright systolic blood pressure of ≥140 mm Hg.
RESULTS We analyzed the data of 2065 participants who had been enrolled until December 31, 2022. The mean age was 73.2±5.6 years, and 52.0% were female. The mean blood pressure was 137.1±14.9/75.1±9.7 mm Hg. Among the participants, 1886 (91.3%) showed normal response after standing, but 94 (4.6%) had orthostatic hypertension, and 85 (4.1%) had orthostatic hypotension. Orthostatic hypertension was associated with female sex, obesity, cognitive function, physical frailty, and lower quality of life. In the multivariable analysis, body mass index and frailty status were independently associated with orthostatic hypertension.
CONCLUSIONS Orthostatic hypertension is associated with physical frailty, cognitive impairment, and low quality of life in older patients with hypertension. Therefore, evaluation of orthostatic blood pressure changes to confirm orthostatic hypertension or hypotension in frail older adults will serve as an important diagnostic procedure in vulnerable patients. Further studies are required to identify the underlying mechanisms of this association.
Keywords
agedblood pressurefrailtyorthostatic hypertension
Conflict of interest statement
Disclosures K.-i. Kim had full access to all the data in the study and takes responsibility for its integrity and the data analysis. Data from this study is not publicly available as the consent given by the participants does not allow for storage of individual-level data in repositories or journals. Researchers who want to access the data set for replication should submit a request to the corresponding author. Data access is subject to local and national rules and regulations. All scripts used in data preparation and analysis are publicly available. The other authors report no conflicts.
그 밖의 정보
- 출판 형태
- Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
- 저널
- Hypertension (Dallas, Tex. : 1979) · eISSN 1524-4563
- 전자 출판
- 2024-03-21
- MeSH
- Humans · Female · Male · Aged · Frailty* / physiopathology / epidemiology / diagnosis · Republic of Korea / epidemiology · Hypertension* / physiopathology / epidemiology / diagnosis · Hypotension, Orthostatic / physiopathology / epidemiology / diagnosis · Blood Pressure / physiology · Frail Elderly / statistics & numerical data · Quality of Life · Aged, 80 and over · Hand Strength / physiology · Blood Pressure Determination / methods