[BP.05.02] ORTHOSTATIC BLOOD PRESSURE CHANGES AMONG HYPERTENSIVE AND NON-HYPERTENSIVE PATIENTS WITH ALZHEIMER'S DISEASE. (September 2017)

• Record Type: Journal Article
• Authors: De Heus, R.A.A.; Claassen, J.A.H.R.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523759.69844.40
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Previous studies suggested that patients with Alzheimer's disease (AD) may have increased susceptibility to orthostatic hypotension and that antihypertensive treatment may enhance this. The objective of the current study was to investigate orthostatic blood pressure (BP) changes in relation to hypertension (HT) status and antihypertensive treatment in AD patients. Design and method: In 510 patients with mild-to-moderate probable AD BP was measured in sitting position and 1 min after standing, twice within 6 weeks. All BP measurements were screening and baseline measurements for a clinical trial (NILVAD) on the effect of the calcium-channel-blocker nilvadipine as a disease modifying therapy in AD. For inclusion in this trial the use of calcium-channel-blockers and/or β-blockers was not allowed. BP during screening had to be between 100/65 mmHg and 159/99 mmHg. Patients were classified into 4 categories: no HT, controlled HT, uncontrolled HT and untreated HT, with HT defined as systolic BP (SBP) >139 mmHg and/or diastolic BP (DBP) >89 mmHg on both occasions. Orthostatic hypotension (OHypo) was defined as a decrease of >19 mmHg in SBP or >9 mmHg in DBP. Orthostatic hypertension (OHyper) was defined as an increase of >19 mmHg in SBP or >9 mmHg in DBP. Orthostatic change in SBP and DBP was defined as the absolute difference between sitting and standing. Statistical analyses was performed using AN(C)OVA, Chi-square and Kruskal-Wallis testing (p < 0.05). Results: Results are shown in Table 1. Overall, OHypo was present in 3.3% and OHyper in 10.4% of the study population. After controlling for age, sex and BMI orthostatic SBP decrease was larger in the untreated HT group compared to the controlled HT and no HT group (p = 0.008). In addition, the effects of 18 months use of nilvadipine or placebo on mean BP and orthostatic changes will be available in May 2017. Conclusions: This study showed that orthostatic decrease is more prominent in untreated HT. In contrast with the prevailing hypothesis, orthostatic decrease was not higher in AD patients using antihypertensive medication. In addition to these results, we will present results of the 18 months follow-up during the ESH meeting. Figure. No caption available.