Orthostatic Hypotension among the Elderly Hypertensives in Anambra State, South Eastern Nigeria

Abstract

Background: Orthostatic hypotension is a sustained reduction of systolic blood pressure of at least 20mmHg or diastolic blood pressure of at least 10mmHg within three minutes of standing from supine position. The burden of orthostatic hypotension on public health is substantial, with a prevalence of 7% to 55% in the elderly and is higher in those with risk factors especially hypertension, use of antihypertensive drugs and diabetes mellitus. The objective of this study was to determine the prevalence of orthostatic hypertension among the elderly hypertensives in Anambra State.
Methods: This was a community based cross-sectional study among 400 elderly people aged 60 years and above who were recruited using a multistage sampling method. Data was collected using interviewer administered questionnaire. Mercury sphygmomanometer, weighing scale, stadiometer and glucometer were used to record blood pressure, body weight, height and random blood sugar respectively. Statistical analysis was done using Statistical Package for the Social Sciences version 21 and p value ≤ 0.05 was considered statistically significant.
Results: Most of the participants had either systolic or diastolic hypertension (85.8%). The prevalence of orthostatic hypotension was 14.8% in the study population and 16.3% among those who were hypertensive.  Those with supine diastolic hypertension [OR: 1.699 (95% CI: 0.401-7.209)] were more likely than those without supine diastolic hypertension to have orthostatic hypotension.
Conclusion: The prevalence of orthostatic hypotension among elderly hypertensives aged 60 years and above in Anambra State was found to be relatively high, implying a higher risk of orthostatic hypotension in elderly hypertensives than in normotensives. This finding will aid clinicians in better management of elderly patients which will lead to prevention of the various complications due orthostatic hypotension.