The British journal of general practice : the journal of the Royal College of General Practitioners · 2012
Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study.
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van Hateren Kornelis J J, Kleefstra Nanne, Blanker Marco H, Ubink-Veltmaat Lielith J, Groenier Klaas H, Houweling Sebastiaan T, Kamper Adriaan M, van der Meer Klaas, Bilo Henk J G
Аннотация
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.
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.