Email this article Orthostatic hypotension in patients of 60 years and older with arterial hypertension: an association between arterial stiffness and frailty
- Authors: Luzina A.V.1, Runikhina N.K.1, Tkacheva O.N.1, Lysenkov S.N.1,2, Kotovskaya Y.V.1, Eruslanova K.A.1
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Affiliations:
- Russian Clinical and Research Center of Gerontology
- Lomonosov Moscow State University
- Issue: Vol 49, No 2 (2021)
- Pages: 157-164
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/1452
- DOI: https://doi.org/10.18786/2072-0505-2021-49-017
- ID: 1452
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Abstract
Aim: To assess an association between orthostatic hypotension and arterial stiffness, measured by the cardio-ankle vascular index (CAVI), in a group of patients≥60 years of age with arterial hypertension and frailty.
Materials and methods: The study included 160 patients aged 60 to 101 years with confirmed arterial hypertension without severe concomitant physical disorders. Compliance to the previously prescribed medications was assessed. A short questionnaire, "Age is not a hindrance," was used to identify patients with frailty. According to the current diagnostic algorithm for frailty, the patients were categorized into three groups: group 1, frail, group 2, pre-frail, group 3, healthy. Arterial stiffness was assessed by volumetric sphygmometry (VaSera-VS-1500, Fukuda Denshi, Japan) with the measurement of CAVI. The orthostatic test was considered positive if blood pressure falls by≥20/10 mm Hg after changing from supine to standing position.
Results: The mean age of the study patients was 77.2±8.1 years (n=160), being 72.4±6.9 years in the healthy patients (n=50), 76.6±8.1 years in the pre-frail (n=50) and 81.7±6.6 years in the frail patients (n=60). Orthostatic hypotension was identified in total of 53 (33%) patients, with marginally significant difference between the pre-frail and healthy groups (44 and 20% of the patients, respectively, p=0.053). The CAVI values were higher in frail patients, compared to healthy ones (p=0.0005). Orthostatic hypotension was associated with a higher CAVI, irrespective of the patients’ age and frailty (р=0.0067). The association between orthostatic hypotension and CAVI in frail patients was found only with unifactor analysis, but became non-significant with the additional analysis.
Conclusion: Orthostatic hypotension can be found in 33% of the elderly patients with arterial hypertension. Arterial stiffness increases with increasing frailty, as well as with concomitant orthostatic hypotension in the group of the patients≥60 years of age. The progression of arterial stiffness in the elderly group is heterogeneous and depends on the presence of frailty.
About the authors
A. V. Luzina
Russian Clinical and Research Center of Gerontology
Author for correspondence.
Email: alexalav@mail.ru
ORCID iD: 0000-0002-1695-9107
Alexandra V. Luzina – MD, Junior Research Fellow, Laboratory of Cardiovascular Ageing; Cardiologist
161-ya Leonova ul., Moscow, 129226, Russian Federation
Russian FederationN. K. Runikhina
Russian Clinical and Research Center of Gerontology
Email: nkrunihina@rgnkc.ru
ORCID iD: 0000-0001-5272-0454
Nadezhda K. Runikhina – MD, PhD, Professor, Chair of Ageing Diseases, Deputy Director on Geriatric Medicine
161-ya Leonova ul., Moscow, 129226, Russian Federation
Russian FederationO. N. Tkacheva
Russian Clinical and Research Center of Gerontology
Email: tkacheva@rgnkc.ru
ORCID iD: 0000-0002-4193-688X
Olga N. Tkacheva – MD, PhD, Professor, Chair of Ageing Diseases, Director
161-ya Leonova ul., Moscow, 129226, Russian Federation
Russian FederationS. N. Lysenkov
Russian Clinical and Research Center of Gerontology; Lomonosov Moscow State University
Email: s_lysenkov@mail.ru
ORCID iD: 0000-0002-5791-7712
Sergey N. Lysenkov – Junior Research Fellow, Laboratory of Musculoskeletal Disorders; Senior Research Fellow, Biological Faculty
161-ya Leonova ul., Moscow, 129226, Russian Federation;
1 Leninskie gory, Moscow, 119991, Russian Federation
Russian FederationYu. V. Kotovskaya
Russian Clinical and Research Center of Gerontology
Email: kotovskaya_yv@rgnkc.ru
ORCID iD: 0000-0002-1628-5093
Yulia V. Kotovskaya – MD, PhD, Professor, Deputy Director on Science
161-ya Leonova ul., Moscow, 129226, Russian Federation;
Russian FederationK. A. Eruslanova
Russian Clinical and Research Center of Gerontology
Email: eruslanova_ka@rgnkc.ru
ORCID iD: 0000-0003-0048-268X
Kseniia A. Eruslanova – MD, Junior Research Fellow, Laboratory of Cardiovascular Ageing
161-ya Leonova ul., Moscow, 129226, Russian Federation;
Russian FederationReferences
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