Volume 114, Nº 6, June 2020
DOI: https://doi.org/10.36660/abc.20180354
ORIGINAL ARTICLE
Prevalence of Orthostatic Hypotension and the Distribution of Pressure Variation in the Longitudinal Study of Adult Health
Ana Paula Costa Velten
Isabela Bensenor
Paulo Lotufo
José Geraldo Mill
Abstract
Background: Orthostatic hypotension (OH) has been neglected in clinical practice, and there are no studies on its prevalence in the Brazilian population.
Objective: To determine the prevalence of OH and blood pressure (BP) changes after the postural change maneuver in participants of the Longitudinal Study of Adult Health.
Methods: In this descriptive study of baseline data (N = 14,833 adults, ages 35 – 74 years), participants remained lying down for 20 minutes and subsequently stood up actively. BP measurements were taken while the participants were supine and at 2, 3, and 5 minutes after standing. OH was defined as a reduction of ≥ 20 mmHg in systolic BP and/or a reduction of ≥ 10 mmHg in diastolic BP at 3 minutes, and its prevalence was determined with a 95% confidence interval (CI). The distribution of BP variation after the postural change maneuver was determined in a subsample (N = 8,011) obtained by removing patients with cardiovascular morbidity and/or diabetes.
Results: The prevalence of OH was 2.0% (95% CI: 1.8 – 2.3), increasing with age. If the criterion applied were a BP reduction during any measurement, the prevalence would increase to 4.3% (95% CI: 4.0 – 4.7). Symptoms (dizziness, scotoma, nausea, etc.) were reported by 19.7% of participants (95% CI: 15.6 – 24.6) with OH and 1.4% (95% CI: 1.2 – 1.6) of participants without OH. The −2 Z-scores of BP variation before and after the postural change maneuver in the subsample were −14.1 mmHg for systolic BP and −5.4 mmHg for diastolic BP.
Conclusion: Prevalence of OH varies depending on when BP is measured. Current cutoff points may underestimate the actual occurrence of OH in the population. (Arq Bras Cardiol. 2020; 114(6):1040-1048)
Keywords: Hypotension, Orthostatic/epidemiology; Prevalence; Coronary Artery Disease; Blood Pressure; Standing Position.
