Orthostatic hypotension in the healthy elderly

Orthostatic hypotension (OH) is a common problem in elderly people causing several complications such as falls and fractures. In recent years, it was noticed that OH seems to have an association with cardiovascular risk factors including cerebrovascular events, higher nocturnal blood pressure levels, and arterial stiffness. In this study, we aimed to evaluate the prevalence of OH in our healthy elderly people and its association with blood pressures, left ventricular mass, plasma insulin, age, and autonomic tests including heart rate response (HRR) to valsalva maneuver, heart rate variation (HRV) during deep breathing, HRR to standing. A total of 61 subjects (35 male/26 female) were enrolled and completed the study. Nine out of 61 (14.7%) were found to have OH. When demographic features and study parameters were compared in both groups (subjects with OH: 9 and non-OH: 52), no difference in blood glucose, sodium, potassium, calcium, body mass index, systolic and diastolic blood pressures, HRR to valsalva maneuver, HRV during deep breathing, HRR to standing were found between the groups. While fasting plasma insulin level was significantly higher in non-OH group than those in OH group (p<0.05), left ventricular mass index was significantly higher in subjects with OH (p<0.05). In conclusion, OH is a prevalent condition in healthy elderly people and its relation with cardiovascular risk factors like increased left ventricular mass index and impaired blood pressure control need more studies to demonstrate such an association and responsible mechanisms.