Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study

Kornelis J. J. van Hateren*, Nanne Kleefstra, Marco H. Blanker, Lielith J. Ubink-Veltmaat, Klaas H. Groenier, Sebastiaan Houweling, Adriaan M. Kemper, Klaas van der Meer, Henk J. G. Bilo

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background:

Although orthostatic hypotension (OH) is more prevalent in old age, and in patients with diabetes, the prevalence of OH in older patients with type 2 diabetes mellitus is unknown.

Aim:

To establish the prevalence of OH, and its association with falling, in home-dwelling older participants with and without type 2 diabetes.

Design and setting:

A cross-sectional study in primary care in the Netherlands.

Method:

A total of 352 patients with type 2 diabetes, and 211 without participated in this study. OH was defined as a fall in blood pressure of at least 20 mmHg systolic or 10 mmHg diastolic after either 1 or 3 minutes in an upright position. Feelings of dizziness, light-headedness, or faintness during the standing period were documented as orthostatic complaints. Fall risk was assessed with a validated risk profile instrument.

Results:

The prevalence of OH was 28% (95% CI = 24% to 33%) and 18% (95% CI = 13% to 23%) in participants with and without type 2 diabetes, respectively. OH was not related to falling, while the presence of orthostatic complaints in itself was associated with both previous fall incidents as well as a high fall risk, even after adjustment for OH. The adjusted odds ratios were 1.65 (95% CI = 1.00 to 2.72) and 8.21 (95% CI = 4.17 to 16.19), respectively.

Conclusion:

OH is highly prevalent in home-dwelling older people with and without type 2 diabetes. Those with orthostatic complaints had an increased risk for falling, whereas those with OH were not.

Original languageEnglish
Pages (from-to)e696-e702
Number of pages7
JournalBritish Journal of General Practice
Volume62
Issue number603
DOIs
Publication statusPublished - 1-Oct-2012

Keywords

  • RISK-INCREASING DRUGS
  • BLOOD-PRESSURE
  • NURSING-HOME
  • POPULATION
  • PREVALENCE
  • PEOPLE
  • WITHDRAWAL

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