Standing Up Slowly Antagonises Initial Blood Pressure Decrease in Older Adults with Orthostatic Hypotension

Eline S. De Bruïne, Esmee M. Reijnierse, Marijke C. Trappenburg, Jantsje H. Pasma, Oscar J. De Vries, Carel G M Meskers, Andrea B. Maier

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Orthostatic hypotension (OH) is common in older adults and associated with increased morbidity and mortality, loss of independence and high health-care costs. Standing up slowly is a recommended non-pharmacological intervention. However, the effectiveness of this advice has not been well studied. Objectives: The aim of this study was to investigate whether standing up slowly antagonises posture-related blood pressure (BP) decrease in a clinically relevant population of geriatric outpatients. Methods: In this cross-sectional study, 24 community-dwelling older adults referred to a geriatric outpatient clinic and diagnosed with OH were included. BP was measured continuously during 3 consecutive transitions from supine to standing position during normal, slow and fast transition. Results: The relative BP decrease at 0-15 s after slow transition was significantly lower than after normal transition (p = 0.003 for both systolic BP and diastolic BP) and fast transition (p = 0.045 for systolic BP; diastolic BP: non-significant). The relative diastolic BP decrease at 60-180 s after normal transition was significantly lower than after fast transition (p = 0.029). Conclusion: Standing up slowly antagonises BP decrease predominantly during the first 15 s of standing up in a clinically relevant population of geriatric outpatients diagnosed with OH. Results support the non-pharmacological intervention in clinical practice to counteract OH.

Original languageEnglish
Pages (from-to)137-143
Number of pages7
JournalGerontology
Volume63
Issue number2
DOIs
Publication statusPublished - 1 Feb 2017

Cite this

@article{3f62fba11dd5478c824d61b9e35585da,
title = "Standing Up Slowly Antagonises Initial Blood Pressure Decrease in Older Adults with Orthostatic Hypotension",
abstract = "Background: Orthostatic hypotension (OH) is common in older adults and associated with increased morbidity and mortality, loss of independence and high health-care costs. Standing up slowly is a recommended non-pharmacological intervention. However, the effectiveness of this advice has not been well studied. Objectives: The aim of this study was to investigate whether standing up slowly antagonises posture-related blood pressure (BP) decrease in a clinically relevant population of geriatric outpatients. Methods: In this cross-sectional study, 24 community-dwelling older adults referred to a geriatric outpatient clinic and diagnosed with OH were included. BP was measured continuously during 3 consecutive transitions from supine to standing position during normal, slow and fast transition. Results: The relative BP decrease at 0-15 s after slow transition was significantly lower than after normal transition (p = 0.003 for both systolic BP and diastolic BP) and fast transition (p = 0.045 for systolic BP; diastolic BP: non-significant). The relative diastolic BP decrease at 60-180 s after normal transition was significantly lower than after fast transition (p = 0.029). Conclusion: Standing up slowly antagonises BP decrease predominantly during the first 15 s of standing up in a clinically relevant population of geriatric outpatients diagnosed with OH. Results support the non-pharmacological intervention in clinical practice to counteract OH.",
keywords = "Blood pressure, Continuously measured blood pressure, Older adults, Orthostatic hypotension, Stance, Standing up slowly",
author = "{De Bru{\"i}ne}, {Eline S.} and Reijnierse, {Esmee M.} and Trappenburg, {Marijke C.} and Pasma, {Jantsje H.} and {De Vries}, {Oscar J.} and Meskers, {Carel G M} and Maier, {Andrea B.}",
year = "2017",
month = "2",
day = "1",
doi = "10.1159/000450642",
language = "English",
volume = "63",
pages = "137--143",
journal = "Gerontology",
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number = "2",

}

Standing Up Slowly Antagonises Initial Blood Pressure Decrease in Older Adults with Orthostatic Hypotension. / De Bruïne, Eline S.; Reijnierse, Esmee M.; Trappenburg, Marijke C.; Pasma, Jantsje H.; De Vries, Oscar J.; Meskers, Carel G M; Maier, Andrea B.

In: Gerontology, Vol. 63, No. 2, 01.02.2017, p. 137-143.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Standing Up Slowly Antagonises Initial Blood Pressure Decrease in Older Adults with Orthostatic Hypotension

AU - De Bruïne, Eline S.

AU - Reijnierse, Esmee M.

AU - Trappenburg, Marijke C.

AU - Pasma, Jantsje H.

AU - De Vries, Oscar J.

AU - Meskers, Carel G M

AU - Maier, Andrea B.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: Orthostatic hypotension (OH) is common in older adults and associated with increased morbidity and mortality, loss of independence and high health-care costs. Standing up slowly is a recommended non-pharmacological intervention. However, the effectiveness of this advice has not been well studied. Objectives: The aim of this study was to investigate whether standing up slowly antagonises posture-related blood pressure (BP) decrease in a clinically relevant population of geriatric outpatients. Methods: In this cross-sectional study, 24 community-dwelling older adults referred to a geriatric outpatient clinic and diagnosed with OH were included. BP was measured continuously during 3 consecutive transitions from supine to standing position during normal, slow and fast transition. Results: The relative BP decrease at 0-15 s after slow transition was significantly lower than after normal transition (p = 0.003 for both systolic BP and diastolic BP) and fast transition (p = 0.045 for systolic BP; diastolic BP: non-significant). The relative diastolic BP decrease at 60-180 s after normal transition was significantly lower than after fast transition (p = 0.029). Conclusion: Standing up slowly antagonises BP decrease predominantly during the first 15 s of standing up in a clinically relevant population of geriatric outpatients diagnosed with OH. Results support the non-pharmacological intervention in clinical practice to counteract OH.

AB - Background: Orthostatic hypotension (OH) is common in older adults and associated with increased morbidity and mortality, loss of independence and high health-care costs. Standing up slowly is a recommended non-pharmacological intervention. However, the effectiveness of this advice has not been well studied. Objectives: The aim of this study was to investigate whether standing up slowly antagonises posture-related blood pressure (BP) decrease in a clinically relevant population of geriatric outpatients. Methods: In this cross-sectional study, 24 community-dwelling older adults referred to a geriatric outpatient clinic and diagnosed with OH were included. BP was measured continuously during 3 consecutive transitions from supine to standing position during normal, slow and fast transition. Results: The relative BP decrease at 0-15 s after slow transition was significantly lower than after normal transition (p = 0.003 for both systolic BP and diastolic BP) and fast transition (p = 0.045 for systolic BP; diastolic BP: non-significant). The relative diastolic BP decrease at 60-180 s after normal transition was significantly lower than after fast transition (p = 0.029). Conclusion: Standing up slowly antagonises BP decrease predominantly during the first 15 s of standing up in a clinically relevant population of geriatric outpatients diagnosed with OH. Results support the non-pharmacological intervention in clinical practice to counteract OH.

KW - Blood pressure

KW - Continuously measured blood pressure

KW - Older adults

KW - Orthostatic hypotension

KW - Stance

KW - Standing up slowly

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JO - Gerontology

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SN - 0304-324X

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ER -