@article{ref1,
title="Orthostatic hypotension in middle-age and risk of falls",
journal="American journal of hypertension",
year="2016",
author="Juraschek, Stephen P. and Daya, Natalie and Appel, Lawrence J. and Miller, Edgar R. and Windham, Beverly Gwen and Pompeii, Lisa and Griswold, Michael E. and Kucharska-Newton, Anna and Selvin, Elizabeth",
volume="30",
number="2",
pages="188-195",
abstract="BACKGROUND: One-third of older adults fall each year. Orthostatic hypotension (OH) has been hypothesized as an important risk factor for falls, but findings from prior studies have been inconsistent. <br><br>METHODS: We conducted a prospective study of the association between baseline OH (1987-1989) and risk of falls in the Atherosclerosis Risk in Communities (ARIC) Study. Falls were ascertained during follow-up via ICD-9 hospital discharge codes or Centers for Medicare & Medicaid Services claims data. OH was defined as a drop in systolic blood pressure (SBP) ≥20mm Hg or diastolic blood pressure (DBP) ≥10mm Hg within 2 minutes of moving from the supine to standing position. Changes in SBP or DBP during OH assessments were also examined as continuous variables. <br><br>RESULTS: During a median follow-up of 23 years, there were 2,384 falls among 12,661 participants (mean age 54 years, 55% women, 26% black). OH was associated with risk of falls even after adjustment for demographic characteristics and other risk factors (hazard ratio (HR): 1.30; 95% confidence interval (CI): 1.10, 1.54; P = 0.002). Postural change in DBP was more significantly associated with risk of falls (HR 1.09 per -5mm Hg change in DBP; 95% CI: 1.05, 1.13; P < 0.001) than postural change in SBP (HR 1.03 per -5mm Hg change in SBP; 95% CI: 1.01, 1.05; P = 0.002). <br><br>CONCLUSIONS: In a community-based, middle-aged population, OH, and in particular, postural change in DBP, were independent risk factors for falls over 2 decades of follow-up. Future studies are needed to examine OH thresholds associated with increased risk of falls.<br><br>© American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.<p /> <p>Language: en</p>",
language="en",
issn="0895-7061",
doi="10.1093/ajh/hpw108",
url="http://dx.doi.org/10.1093/ajh/hpw108"
}