Study offers critical insights into the assessment of orthostatic hypotension among older adults

Reviewed by Megan Craig, M.Sc.Nov 7 2023

A new study, "Timing of Orthostatic Hypotension and its Relationship with Falls in Older Adults", has brought critical insights into the assessment of orthostatic hypotension, a drop in blood pressure commonly found among older adults when transitioning from a sitting or lying position to a standing position that can lead to dizziness and falls.

Published in the Journal of the American Geriatrics Society (JAGS) and based on a secondary analysis of the "Study to Understand Fall Reduction and Vitamin D in You (STURDY)," this study examined the prevalence of orthostatic hypotension at different time points after standing in a population of older adults, and it also explored the association between orthostatic hypotension and fall risk.

Key findings from the study, which involved community-dwelling adults aged 70 and older, revealed that orthostatic hypotension was most prevalent and symptomatic within 1-2 minutes after standing. However, the study also demonstrated that orthostatic hypotension assessments conducted after 4 to 6 minutes of standing were more informative for predicting fall risk.

According to Lewis A. Lipsitz, MD, Director, Hebrew SeniorLife Marcus Institute for Aging Research and Hebrew SeniorLife's Chief Academic Officer, "The findings have important implications because falls represent a major cause of serious, life-threatening injury in older adults, and understanding the timing of orthostatic hypotension assessments can help clinicians identify those at highest risk and institute appropriate interventions to reduce falls and related injuries."

The lead author was Aldis H. Petriceks, BA, Harvard Medical School. Co-authors include:

• Lawrence J. Appel, MD, MPH, Director of the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health;
• Edgar R. Miller 3rd, MD, PhD, Deputy Director, Johns Hopkins Institute for Clinical and Translational Science;
• Christine M. Mitchell, ScM, Senior Research Associate, Johns Hopkins Bloomberg School of Public Health;
• Jennifer A. Schrack, PhD, MS, Professor, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Center on Aging and Health;
• Kenneth J. Mukamal, MD, MPH, MA, Department Associate, Beth Israel Deaconess Medical Center;
• Lewis A. Lipsitz, MD, Irving and Edyth S. Usen and Family Chair in Medical Research, Hebrew SeniorLife, Professor of Medicine, Harvard Medical School and Chief, Division of Gerontology, Beth Israel Deaconess Medical Center;
• Amal A. Wanigatunga, PhD, MPH, Assistant Professor, Johns Hopkins Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health;
• Timothy B. Plante, MD, Associate Director of Preventive Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease MHS, Assistant Professor, University of Vermont Medical Center;
• Erin D. Michos, MD, MHS, Associate Director of Preventive Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, The Johns Hopkins University School of Medicine; and
• Stephen P. Juraschek, MD, PhD, Section for Research, Division of General Medicine, Beth Israel Deaconess Medical Center.

This work was supported by the Johns Hopkins Institute for Clinical and Translation Research, Grant/Award; Number: UL1TR003098; Mid-Atlantic Nutrition Obesity Research Center, Grant/Award Number: P30DK072488; National Heart, Lung, and Blood Institute, Grant/Award Number: 7K23HL135273; National Institute on Aging, Grant/Award Numbers: 5K24AG065525, U01AG047837.