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Br J Gen Pract. 2012 Oct;62(603):e696-702. doi: 10.3399/bjgp12X656838.

Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study.

Author information

1
Diabetes Centre, Isala Clinics, Zwolle, The Netherlands. k.j.j.van.hateren@isala.nl

Abstract

BACKGROUND:

Although orthostatic hypotension (OH) is more prevalent in old age, and in patients with diabetes, the prevalence of OH in older patients with type 2 diabetes mellitus is unknown.

AIM:

To establish the prevalence of OH, and its association with falling, in home-dwelling older participants with and without type 2 diabetes.

DESIGN AND SETTING:

A cross-sectional study in primary care in the Netherlands.

METHOD:

A total of 352 patients with type 2 diabetes, and 211 without participated in this study. OH was defined as a fall in blood pressure of at least 20 mmHg systolic or 10 mmHg diastolic after either 1 or 3 minutes in an upright position. Feelings of dizziness, light-headedness, or faintness during the standing period were documented as orthostatic complaints. Fall risk was assessed with a validated risk profile instrument.

RESULTS:

The prevalence of OH was 28% (95% CI = 24% to 33%) and 18% (95% CI = 13% to 23%) in participants with and without type 2 diabetes, respectively. OH was not related to falling, while the presence of orthostatic complaints in itself was associated with both previous fall incidents as well as a high fall risk, even after adjustment for OH. The adjusted odds ratios were 1.65 (95% CI = 1.00 to 2.72) and 8.21 (95% CI = 4.17 to 16.19), respectively.

CONCLUSION:

OH is highly prevalent in home-dwelling older people with and without type 2 diabetes. Those with orthostatic complaints had an increased risk for falling, whereas those with OH were not.

PMID:
23265229
PMCID:
PMC3459777
DOI:
10.3399/bjgp12X656838
[Indexed for MEDLINE]
Free PMC Article

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