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Current Hypertension Reviews

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ISSN (Print): 1573-4021
ISSN (Online): 1875-6506

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Cross-Sectional Study

Synchronous Bilateral Brachial Blood Pressure Measurements Increased Orthostatic Hypotension Detection in the Elderly

Author(s): Jianying Zhang, Xia Gao, Benxu Ma, Lili Liu and Huanmin Gao*

Volume 20, Issue 1, 2024

Published on: 28 December, 2023

Page: [57 - 63] Pages: 7

DOI: 10.2174/0115734021269751231204114902

Price: $65

Abstract

Background: Orthostatic hypotension (OH) is a common clinical sign, but its detection rate is low, and it is difficult to repeat because there is no standardized screening method available.

Aim: This study aimed to establish a method for detecting blood pressure and assess whether it could increase the OH detection rate in the elderly.

Methods: From May to October, 2022, 178 patients with symptomatic OH and 286 subjects with asymptomatic OH were selected. BP from the bilateral brachial artery was measured using two electronic sphygmomanometers on both arms at the same time, in the order of supine, sitting, and standing at 0-3 min. OH should meet 20/10 mmHg, standing BP minus sitting BP. The OH detection rates were calculated and compared. The symptomatic OH group was more often older, slimmer, had lower ADL scores, and contained fewer smokers (all P< 0.05).

Results: The detection rate of the symptomatic OH group using the modified method was 59.55%, which was higher than that of the routine method (34.83% vs. 59.55%, P<0.05). The detection rate using the modified method in the OH group with asymptomatic OH was 20.63%, which was higher than that of the routine method (20.63% vs. 5.59%, P< 0.01).

Conclusion: Synchronous measurement of bilateral brachial artery BP in supine, sitting, and standing positions increased the detection rate of OH in the elderly.

Keywords: Orthostatic hypotension, synchronous, detection rate, elderly, artery, blood pressure.

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[1]
Ricci F, De Caterina R, Fedorowski A. Orthostatic hypotension. J Am Coll Cardiol 2015; 66(7): 848-60.
[http://dx.doi.org/10.1016/j.jacc.2015.06.1084] [PMID: 26271068]
[2]
Gibbons CH, Schmidt P, Biaggioni I, et al. The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. J Neurol 2017; 264(8): 1567-82.
[http://dx.doi.org/10.1007/s00415-016-8375-x] [PMID: 28050656]
[3]
Palma JA, Kaufmann H. Management of orthostatic hypotension. Continuum 2020; 26(1): 154-77.
[http://dx.doi.org/10.1212/CON.0000000000000816] [PMID: 31996627]
[4]
Fanciulli A, Leys F, Falup-Pecurariu C, Thijs R, Wenning GK. Management of orthostatic hypotension in Parkinson’s Disease. J Parkinsons Dis 2020; 10(s1): S57-64.
[http://dx.doi.org/10.3233/JPD-202036] [PMID: 32716319]
[5]
Merola A, Romagnolo A, Rosso M, et al. Orthostatic hypotension in Parkinson’s disease: Does it matter if asymptomatic? Parkinsonism Relat Disord 2016; 33: 65-71.
[http://dx.doi.org/10.1016/j.parkreldis.2016.09.013] [PMID: 27641792]
[6]
Ward C, Kenny RA. Reproducibility of orthostatic hypotension in symptomatic elderly. Am J Med 1996; 100(4): 418-22.
[http://dx.doi.org/10.1016/S0002-9343(97)89517-4] [PMID: 8610728]
[7]
Ziegler D, Laux G, Dannehl K, et al. Assessment of cardiovascular autonomic function: Age-related normal ranges and reproducibility of spectral analysis, vector analysis, and standard tests of heart rate variation and blood pressure responses. Diabet Med 1992; 9(2): 166-75.
[http://dx.doi.org/10.1111/j.1464-5491.1992.tb01754.x] [PMID: 1563252]
[8]
Park JW, Okamoto LE, Shibao CA, Biaggioni I. Pharmacologic treatment of orthostatic hypotension. Auton Neurosci 2020; 229: 102721.
[http://dx.doi.org/10.1016/j.autneu.2020.102721] [PMID: 32979782]
[9]
Naschitz JE, Slobodin G, Elias N, Rosner I. The patient with supine hypertension and orthostatic hypotension: A clinical dilemma. Postgrad Med J 2006; 82(966): 246-53.
[http://dx.doi.org/10.1136/pgmj.2005.037457] [PMID: 16597811]
[10]
Stergiou GS, Palatini P, Parati G, et al. 2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement. J Hypertens 2021; 39(7): 1293-302.
[http://dx.doi.org/10.1097/HJH.0000000000002843] [PMID: 33710173]
[11]
Chinese expert consensus on adult limb blood pressure measurement. Chin J Cardiovascular Dis 2021; 49(10): 963-71.
[12]
Shen DT. Effect of timing and frequency of orthostatic blood pressure measurement on detection rate of orthostatic hypotension. Chin J Hypertens 2014; 22(06): 571-5.
[13]
Stergiou GS, Parati G, McManus RJ, Head GA, Myers MG, Whelton PK. Guidelines for blood pressure measurement: Development over 30 years. J Clin Hypertens 2018; 20(7): 1089-91.
[http://dx.doi.org/10.1111/jch.13295] [PMID: 30003695]
[14]
Wieling W, Kaufmann H, Claydon VE, et al. Diagnosis and treatment of orthostatic hypotension. Lancet Neurol 2022; 21(8): 735-46.
[http://dx.doi.org/10.1016/S1474-4422(22)00169-7] [PMID: 35841911]
[15]
Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 1996; 46(5): 1470.
[http://dx.doi.org/10.1212/WNL.46.5.1470] [PMID: 8628505]

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