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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Clin+Med+Res
2018 ; 10
(4
): 309-313
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Comparison of the Assessment of Orthostatic Hypotension Using Peripheral and
Central Blood Pressure Measurements
#MMPMID29511419
Alagiakrishnan K
; Bu R
; Hamilton P
; Senthilselvan A
; Padwal R
J Clin Med Res
2018[Apr]; 10
(4
): 309-313
PMID29511419
show ga
BACKGROUND: Orthostatic hypotension (OH) is associated with falls and
cardiovascular events. There is growing evidence that central blood pressure
(CBP) is better than peripheral blood pressure (PBP) in predicting adverse
outcomes. The objectives of this study were to assess 1) the prevalence of OH
identified using PBP and CBP and the levels of agreement, 2) the respective
associations between OH and falls and cardiovascular comorbidities, by PBP and
CBP, and 3) the association of OH with arterial wall stiffness markers
(augmentation pressure (AP) and augmentation index (AI)). METHODS: An
observational case-control study of subjects aged 50 years and above was
conducted at the University of Alberta Hospital inpatient wards and outpatient
clinics. This study used a non-invasive technology called SphygmoCor to assess
changes in CBP between lying, 1, 3 and 6 min of standing. AP and AI, which are
markers of arterial wall stiffness, were also measured in this study. Dementia,
significant psychological problems, and isolation precautions were exclusion
criteria. Both PBP and CBP were measured with arm cuffs in lying and standing
positions. OH was diagnosed using consensus criteria. RESULTS: Of the 71
participants recruited, mean age was 72.3 ±10.3 years, 52% were males, 32% had a
history of falls and 72% had hypertension. OH occurred within 1, 3 or 6 min of
standing (transient OH) in 31% by PBP and 27% by CBP (kappa = 0.56). OH persisted
for all 6 min (persistent OH) in 16% by both PBP and CBP (kappa = 0.68). A
significant relationship was observed between transient OH by CBP and baseline
hypertension (P = 0.05) and dyslipidemia (P = 0.02). There was a significant
difference in the mean AP between subjects with and without central persistent OH
(P = 0.02), but not between subjects with and without peripheral persistent OH.
The mean AI was not significantly different between subjects with or without
central or peripheral persistent OH and between subjects with and without
peripheral or central transient OH. CONCLUSION: Prevalence of OH was similar
between PBP and CBP. However, there was only moderate agreement with OH
identified by PBP and CBP indicating some inconsistencies across the sample in
identifying OH.