@article{ref1,
title="Postural blood pressure electrocardiographic changes are associated with falls in older people",
journal="Clinical autonomic research",
year="2015",
author="Saedon, Nor Izzati and Zainal-Abidin, Imran and Chee, Kok Han and Khor, Hui Min and Tan, Kit Mun and Kamaruzzaman, Shahrul K. and Chin, Ai-Vyrn and Poi, Philip J. H. and Tan, Maw Pin",
volume="26",
number="1",
pages="41-48",
abstract="OBJECTIVES: To determine the magnitude of postural blood pressure change, differences in ECG between fallers and non-fallers were measured. Postural blood pressure change is associated with symptoms of dizziness, presyncope, and syncope. <br><br>METHODS: In this cross-sectional study were included participants from The Malaysian Falls Assessment and Intervention Trial: fallers, aged 65 years or older with two or more falls or one injurious fall in 12 months, from a teaching hospital; and non-fallers, aged 65 years and older found through word-of-mouth and advertising. Noninvasive beat-to-beat blood pressure was measured at 10 min supine rest and 3 min standing. The maximal drop in systolic and diastolic pressure was calculated from a 12-lead ECG interpreted by a cardiologist. Basic demographics, medical history, and symptoms of dizziness, presyncope, and syncope were recorded for all patients. <br><br>RESULTS: We recruited 155 fallers and 112 non-fallers. Fallers had a significantly longer PR interval (179 ± 32 vs. 168 ± 27 ms, p = 0.013) and a longer corrected QT interval (449 ± 41 vs. 443 ± 39 msec, p = 0.008), and larger change in SBP (28 ± 14 vs. 19 ± 9 mmHg, p < 0.001) with posture change. SBP drop of ≥30mmHg associated with recurrent and injurious falls [odds ratio [95 % confidence interval] = 7.61 (3.18-18.21)]. The changes remained significant after adjustment for symptoms of dizziness, presyncope and syncope. <br><br>INTERPRETATION: Older individuals with recurrent and injurious falls have significantly longer PR and QT intervals and larger SBP reduction with posture change as compared to non-fallers, and these are not explained by the presence of dizziness, presyncope, or syncope. SBP cut-off of ≥30mmHg considered for postural measurements using continuous BP monitors, the significance of this value needs to be evaluated.<p /> <p>Language: en</p>",
language="en",
issn="0959-9851",
doi="10.1007/s10286-015-0327-5",
url="http://dx.doi.org/10.1007/s10286-015-0327-5"
}