ORTHOSTATIC HYPOTENSION AT DISCHARGE - ASSOCIATED CHARACTERISTICS AND OUTCOMES. (June 2022)

• Record Type: Journal Article
• Authors: Gouveia, Rita; Matias, Paula F.; Matos, Mariana; Madureira, Sergio; Veiga, Hugo; Vale, Catarina; Almeida, Jorge; Marques, Pedro S.
• Is Part Of: Journal of hypertension. Volume 40(2022)Supplement 1
• Page Start: e100
• Page End: e101
• Publication Date: 2022-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000836240.31742.92
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Orthostatic hypotension (OH) is a fall in systolic blood pressure (BP) > = 20 mmHg or diastolic BP > = 10 mmHg in the 3 minutes after standing. OH is associated with falls, cognitive impairment and cardiovascular disease. Hospitalized patients may be particularly prone to OH and vulnerable to its consequences due to acute illness, prolonged bed rest and drug treatment. We aimed to evaluate the prevalence of OH at discharge, determine the characteristics of these patients and understand if a positive OH test (+OHt) was associated to worse outcomes. Design and method: Retrospective analysis of 150 patients ospitalised in an internal medicine ward, who were able to tolerate an OH test according to the European Society of Cardiology recommendations. Test was performed at discharge using Erkameter 125 Pro device validated by the European Society of Hypertension. The primary outcome was a composite of death, rehospitalization or emergency department visit for any cause. Data was analysed using IBM SPSS 28. Student t and chi-square tests were used to compare continuous and categorical variables, respectively, and Kaplan-Meier test to perform survival analysis. Results: Table 1 describes patients' characteristics. 58 (39%) had a discharge + OHt but only 7 (12%) were symptomatic. Age was significantly associated with +OHt (p < 0.001), while sex, past medical history or medication at discharge weren't. 71 primary outcome events were considered for survival analysis during a median (interquartile range) follow up of 4 (2–7) months. There were no differences between OHt result groups (p = 0.476). Although there were a small number of symptomatic +OHt patients, these had a higher event rate after discharge (p = 0.02). Conclusions: In an old, predominantly male population with excessive cardiovascular risk, comorbidities and polypharmacy there was a high OH prevalence at discharge. Only age seemed to correlate with OH. Short time prognosis was not affected by OH. The study limitations, small sample size, low number of events and short follow up, may have impacted the analysis. Nevertheless, patients with a symptomatic +OHt at discharge seem to be at higher event risk in which intervention could be helpful.