Prevalence of orthostatic hypotension in a series of elderly Mexican institutionalized patients.

BACKGROUND

Orthostatic hypotension (OH) is a common problem among the elderly. It is associated with an increase in morbidity and mortality, but its prevalence in Mexico is unknown.

METHODS

We conducted a cross-sectional prospective study of intern patients at several Mexican elderly assistance institutions. We carried out a history and took blood pressure readings in a seated position, immediately after standing up, and again after 3 min of standing up.

RESULTS

We evaluated 132 patients, mean age 82.3 ± 9.5 years, 74.1% of them female. Thirty-nine (29.3%) subjects had OH. They had a higher prevalence of hypothyroidism, Parkinson's disease, depression and alcoholism. Their Minimental result was 15.45 ± 7.2 vs 16.12 ± 7.9 (p = 0.6) among those without OH, and their quality of life (Minnesota scale) was 12.1 ± 7.3 vs 9.15 ± 7.05 (p = 0.03). They used more ACEI, digoxin and levothyroxin. Hypertension and alcoholism showed respectively a RR of 2.6 (95% CI 0.9-7.6, p = 0.06) and 3.18 (95% CI 0.96-10.48, p = 0.05) to develop OH.

CONCLUSIONS

OH was present in 29.3% of the studied population. A third of them had hypertension. The use of different medications does not solely explain OH, so it is necessary to look for different associations. Among those, chronic alcoholism stands out. OH is associated with a poorer quality of life and cognitive performance. OH is asymptomatic in most cases.