56 * IMPAIRED ORTHOSTATIC BLOOD PRESSURE CONTROL IS ASSOCIATED WITH FALLS IN COMMUNITY DWELLING ADULTS AGED OVER 50: FINDINGS FROM THE IRISH LONGITUDINAL STUDY ON AGEING

Abstract

Aim: Homeostatic blood pressure responses to standing play a pivotal role in identifying individuals at risk of syncope and unexplained falls. Here we examine the relationship between beat-to-beat orthostatic blood pressure responses and falls in a nationally representative population sample.Methods: Participants were recruited from The Irish Longitudinal Study on Ageing, a nationally representative cohort study of Irish adults aged 50+. Beat-to-beat blood pressure records were analysed among those who underwent an active stand test. Individuals were identified as having orthostatic hypotension (OH), if on standing they demonstrated sustained blood pressure drops of ≥20/10mmHg below resting values at 10 second intervals. Relationships with a history of falls were assessed by logistic regression adjusting for age, gender, education, comorbidities and medications.Results: A sample of N = 4490 older adults was considered. The prevalence of OH is 6.9% (95% CI: 5.9–7.8) being higher in women (8.2% (95% CI: 6.8–9.5) vs. 5.6% (95% CI: 5.9–7.8)) and increases with age to 18.9% (95% CI: 6.21–31.60) in older men. Impaired recovery at 40 seconds, affecting 24.5% (95% CI: 18.9–30.0) of the sample, is associated with an increased odds of having a history of falls OR: 1.57 (95% CI:1.2–2.0); p < 0.001).Conclusions: Using beat-to-beat approaches sustained blood pressure drops at 40 seconds are associated with increased odds of having a falls history. When considering health outcomes in older adults, the time course of blood pressure responses to standing are paramount with impaired recovery at 40 seconds independently associated with falls.