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Influence of orthostatic hypotension on mortality among patients discharged from an acute geriatric ward

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Abstract

BACKGROUND: Orthostatic hypotension (OH) is a common finding among older patients. The impact of OH on mortality is unknown.

OBJECTIVE: To study the long-term effect of OH on total and cardiovascular mortality.

PATIENTS AND METHODS: A total of 471 inpatients (227 males and 244 females), with a mean age of 81.5 years who were hospitalized in an acute geriatric ward between the years 1999 and 2000 were included in the study. Orthostatic tests were performed 3 times during the day on all patients near the time of discharge. Orthostatic hypotension was defined as a fall of at least 20 mmHg in systolic blood pressure (BP) and/or 10mmHg in diastolic BP upon assuming an upright posture at least twice during the day. Patients were followed until August 31, 2004. Mortality data were taken from death certificates.

RESULTS: One hundred and sixty-one patients (34.2%) experienced OH at least twice. Orthostatic hypotension had no effect on all cause and cause specific mortality. Over a follow-up of 3.47±1.87 years 249 patients (52.8%) had died 83 of whom (33.3%) had OH. Age-adjusted mortality rates in those with and without OH were 13.4 and 15.7 per 100 person-years, respectively. Cox proportional hazards model analysis demonstrated that male gender, age, diabetes mellitus, and congestive heart failure increased and high body mass index decreased total mortality.

CONCLUSIONS: Orthostatic hypotension is relatively common in elderly patients discharged from acute geriatric wards, but has no impact on vascular and nonvascular mortality.

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Authors and Affiliations

  1. Geriatric Department, Rabin Medical Center, Israel

    Avraham Weiss MD, Yichayaou Beloosesky MD, Alexandra Yalov MSc & Joseph Grinblat MD

  2. Cardiac Catheterization Laboratories, Department of Cardiology, Rabin Medical Center, Israel

    Ran Kornowski MD

  3. Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel

    Ehud Grossman MD

Authors
  1. Avraham Weiss MD
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  2. Yichayaou Beloosesky MD
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  3. Ran Kornowski MD
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  4. Alexandra Yalov MSc
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  5. Joseph Grinblat MD
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  6. Ehud Grossman MD
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Corresponding author

Correspondence to Ehud Grossman MD.

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None of the authors have any conflicts of interest to declare.

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Weiss, A., Beloosesky, Y., Kornowski, R. et al. Influence of orthostatic hypotension on mortality among patients discharged from an acute geriatric ward. J Gen Intern Med 21, 602–606 (2006). https://doi.org/10.1111/j.1525-1497.2006.00450.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00450.x

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