[Orthostatic and postprandial hypotension in elderly patients with chronic diseases and disability: prevalence and related factors].

Introduction: To assess the prevalence of orthostatic hypotension (OH) and postprandial hypotension (PPH) in patients admitted to an intermediate care unit, as well as to analyze the characteristics of these patients.

Patients And Methods: Sixty patients were analyzed according to the following criteria: age >65 years, able to take food orally, stand up and/or sit down, and clinically stable. A comprehensive geriatric assessment was carried out and the main diagnosis and the presence of autonomic neuropathy symptoms (ANS) were registered. Blood pressure (BP) was registered in the morning in supine position during the first 3min of postural change (standing or sitting). OH was defined as a decrease in systolic blood pressure (SBP) of 20mm Hg or a decrease in diastolic blood pressure (DBP) of 10mmHg. BP was registered after 15min of sitting and 60min after breakfast. PPH was defined as a decrease in SBP of 20mmHg.

Results: The mean age was 79.1+/-7.8 years. Nine patients (15%) had OH and 29 (48.3%) had PPH. The mean Lawton index (LI) score in patients with OH was 3.1+/-2.1 and was 5.2+/-2.6 in the remaining patients (P<.02). The mean body mass index (BMI) was 23.3+/-3.1 vs. 26.2+/-5.1 (P<.04). ANS was present in all nine patients (100%) with OH but in only 30 (58.8%) of the remaining 51 patients (chi-square=5.71; P<.03).

Conclusions: PPH was more frequent than OH. Patients with OH had a significantly lower LI score and BMI. The presence of ANS was significantly more frequent in patients with OH. There was no significant relationship between HO and PPH or among the remaining variables studied.