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Impairments in hemodynamic responses to orthostasis associated with frailty : results from The Irish Longitudinal Study on Ageing (TILDA)
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O’Connell, Matthew, Savva, George M., Finucane, Ciarán, Romero-Ortuno, Roman, Fan, Chie Wei and Kenny, Rose Anne (2018) Impairments in hemodynamic responses to orthostasis associated with frailty : results from The Irish Longitudinal Study on Ageing (TILDA). Journal of the American Geriatrics Society, 66 (8). pp. 1475-1483. doi:10.1111/jgs.15327 ISSN 1532-5415.
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Official URL: https://doi.org/10.1111/jgs.15327
Abstract
Objectives
To characterize the relationships between orthostatic blood pressure (BP) and heart rate recovery and frailty in an older population.
Design
Cross‐sectional study.
Setting
Two health centers in the Republic of Ireland.
Participants
The Irish Longitudinal Study on Ageing participants aged 50 and older (N=4,334).
Measurements
Continuous noninvasive BP responses during active standing were captured using digital photoplethysmography. Frailty was assessed using the Cardiovascular Health Study criteria. Linear mixed models (random intercept) with piecewise splines were used to model differences in rate of BP and heart rate recovery.
Results
Ninety‐three (2.2%) participants were frail, and 1,366 (31.5%) were prefrail. Adjusting for age and sex, frailty was associated with a slower rate of systolic BP recovery 10 to 20 seconds after standing (frailty by time = –4.12, 95% confidence interval=–5.53 to –2.72) and with subsequent deficits in BP 20 to 50 seconds after standing. Similar results were seen for diastolic BP and heart rate. Further adjustment for health behaviors, morbidities, and medications reduced, but did not attenuate, these associations. Of the 5 frailty criteria, only slow gait speed was consistently related to impaired BP and heart rate responses in the full model.
Conclusion
Frailty, particularly slow gait speed, was associated with slower rate of BP and heart rate recovery after active standing. Impaired BP recovery may be a marker of physiological frailty.
Item Type: | Journal Article | ||||||||||||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Hypotension, Orthostatic, Blood pressure, Older people -- Health apsects | ||||||||||||||||||
Journal or Publication Title: | Journal of the American Geriatrics Society | ||||||||||||||||||
Publisher: | Wiley-Blackwell Publishing, Inc. | ||||||||||||||||||
ISSN: | 1532-5415 | ||||||||||||||||||
Official Date: | August 2018 | ||||||||||||||||||
Dates: |
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Volume: | 66 | ||||||||||||||||||
Number: | 8 | ||||||||||||||||||
Page Range: | pp. 1475-1483 | ||||||||||||||||||
DOI: | 10.1111/jgs.15327 | ||||||||||||||||||
Status: | Peer Reviewed | ||||||||||||||||||
Publication Status: | Published | ||||||||||||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||||||||||||
Date of first compliant deposit: | 29 March 2018 | ||||||||||||||||||
Date of first compliant Open Access: | 18 April 2019 | ||||||||||||||||||
RIOXX Funder/Project Grant: |
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