Orthostatic hypotension: Prevalence and associated risk factors among the ambulatory elderly in an Asian population

Abstract

INTRODUCTION The prevalence of orthostatic hypotension (OH) among the elderly population in Singapore,as defined by a decline in blood pressure upon a change in position,is not well-established. Studies associate OH with clinically significant outcomes such as falls. This study aims to determine the prevalence of OH among elderly patients attending a public primary care clinic (polyclinic) for chronic disease management,and examine the relationships between postulated risk factors and OH. METHODS Patients aged ≥ 65 years attending a typical polyclinic in Geylang were identified and targeted for recruitment at the study site. A questionnaire on symptoms and postulated risk factors was administered,followed by supine and standing blood pressure measurements. Cross-sectional analysis was performed with independent sample t-test for continuous data and chi-square test for categorical data. Prevalence rate ratios with 95% confidence interval were calculated for the latter. RESULTS A total of 364 multiethnic patients participated in the study. The prevalence of OH was 11.0%. Older age,comorbidities such as cardiac failure and kidney disease,being physically inactive at work,fatigue,self-reported dizziness in the past year,and the use of loop diuretics were found to be significantly associated with OH. CONCLUSION About one in ten elderly patients at a local polyclinic was affected by OH,which was associated with multiple factors. Some of these factors are modifiable and can be addressed to reduce the incidence of OH.