Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study

• DOI: 10.3399/bjgp12x656838
• Publication Date: 2012-10-03T16:19:52Z
• Authors: Kornelis JJ van H...; Nanne Kleefstra; Marco H Blanker; Lielith J Ubink-V...; Klaas H Groenier; Sebastiaan T Houw...; Adriaan M Kamper; Klaas van der Meer; Henk JG Bilo
• Keywords: Male; General Practice; BLOOD-PRESSURE; Hypotension, Orthostatic; 03 medical and health sciences; 0302 clinical medicine; PEOPLE; Risk Factors; Odds Ratio; Prevalence; Humans; POPULATION; Aged; Netherlands; NURSING-HOME; Blood Pressure Determination; 16. Peace & justice; PREVALENCE; 3. Good health; Cross-Sectional Studies; Logistic Models; RISK-INCREASING DRUGS; Diabetes Mellitus, Type 2; Accidental Falls; Female; Independent Living; WITHDRAWAL

Although orthostatic hypotension (OH) is more prevalent in old age, and in patients with diabetes, the prevalence of OH in older patients with type 2 diabetes mellitus is unknown.To establish the prevalence of OH, and its association with falling, in home-dwelling older participants with and without type 2 diabetes.A cross-sectional study in primary care in the Netherlands.A total of 352 patients with type 2 diabetes, and 211 without participated in this study. OH was defined as a fall in blood pressure of at least 20 mmHg systolic or 10 mmHg diastolic after either 1 or 3 minutes in an upright position. Feelings of dizziness, light-headedness, or faintness during the standing period were documented as orthostatic complaints. Fall risk was assessed with a validated risk profile instrument.The prevalence of OH was 28% (95% CI = 24% to 33%) and 18% (95% CI = 13% to 23%) in participants with and without type 2 diabetes, respectively. OH was not related to falling, while the presence of orthostatic complaints in itself was associated with both previous fall incidents as well as a high fall risk, even after adjustment for OH. The adjusted odds ratios were 1.65 (95% CI = 1.00 to 2.72) and 8.21 (95% CI = 4.17 to 16.19), respectively.OH is highly prevalent in home-dwelling older people with and without type 2 diabetes. Those with orthostatic complaints had an increased risk for falling, whereas those with OH were not.