J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 10, Number 4, April 2018, pages 309-313

Comparison of the Assessment of Orthostatic Hypotension Using Peripheral and Central Blood Pressure Measurements

**Table 1.** Baseline Characteristics of Hypertensive and Normotensive Groups
Variables	Hypertensive^a (n = 51), mean (SD) or no. (%)	Normotensive (n = 20), mean (SD) or no. (%)
^aObtained from medical records. †P < 0.05.
Female	26 (51.0%)	8 (40.0%)
Age (years)	72.6 (11.0)	71.7 (8.5)
BMI (kg/m²)	27.7 (6.0)	26.8 (4.3)
History of orthostatic hypotension	1 (2.0%)	0 (0.0%)
History of falls	14 (27.5%)	9 (45.0%)
Current alcohol use	13 (25.5%)	9 (45.0%)
Current or past smoker	30 (58.8%)	2 (10.0%)
Coronary artery disease	9 (17.6%)	2 (10.0%)
Stroke†	9 (17.6%)	0 (0.0%)
Heart failure	4 (7.8%)	0 (0.0%)
Type II diabetes	15 (29.4%)	2 (10.0%)
Dyslipidemia	22 (43.1%)	4 (20.0%)
Peripheral vascular disease	3 (5.9%)	1 (5.0%)
Chronic kidney disease	2 (3.9%)	1 (5.0%)
Symptoms of orthostatic hypotension	6 (11.8%)	3 (15.0%)
Use of medications associated with orthostatic hypotension†	49 (96.1%)	10 (50.0%)

Table 1. Baseline Characteristics of Hypertensive and Normotensive Groups

Variables

Hypertensive^a (n = 51), mean (SD) or no. (%)

Normotensive (n = 20), mean (SD) or no. (%)

^aObtained from medical records. †P < 0.05.

Female

26 (51.0%)

8 (40.0%)

Age (years)

72.6 (11.0)

71.7 (8.5)

BMI (kg/m²)

27.7 (6.0)

26.8 (4.3)

History of orthostatic hypotension

1 (2.0%)

0 (0.0%)

History of falls

14 (27.5%)

9 (45.0%)

Current alcohol use

13 (25.5%)

9 (45.0%)

Current or past smoker

30 (58.8%)

2 (10.0%)

Coronary artery disease

9 (17.6%)

2 (10.0%)

Stroke†

9 (17.6%)

0 (0.0%)

Heart failure

4 (7.8%)

0 (0.0%)

Type II diabetes

15 (29.4%)

2 (10.0%)

Dyslipidemia

22 (43.1%)

4 (20.0%)

Peripheral vascular disease

3 (5.9%)

1 (5.0%)

Chronic kidney disease

2 (3.9%)

1 (5.0%)

Symptoms of orthostatic hypotension

6 (11.8%)

3 (15.0%)

Use of medications associated with orthostatic hypotension†

49 (96.1%)

10 (50.0%)

**Table 2.** Prevalence and Agreement of Orthostatic Hypotension (OH) by Peripheral and Central Blood Pressures and by Types of Orthostatic Hypotension^a
Types of OH	Peripheral blood pressure (n = 71), no. (%)	Central blood pressure (n = 71), no. (%)	Agreement (kappa^b)
^aEarly OH: at 1 min of standing; OH: at 3 min of standing; delayed OH: at 6 min of standing; transient OH: at 1 or 3 or 6 min of standing; persistent OH: seen at 1, 3, and 6 min of standing. ^bFleiss’s guidelines (Fleiss et al, 2003) characterize kappa > 0.75 as excellent, 0.40 - 0.75 as good, < 0.40 as poor.
Early OH	12 (16.9%)	17 (23.9%)	0.70
OH	19 (26.8%)	12 (16.9%)	0.72
Delayed OH	18 (25.4%)	14 (19.7%)	0.44
Transient OH	22 (31.0%)	19 (26.8%)	0.56
Persistent OH	11 (15.5%)	11 (15.5%)	0.68

Table 2. Prevalence and Agreement of Orthostatic Hypotension (OH) by Peripheral and Central Blood Pressures and by Types of Orthostatic Hypotension^a

Types of OH

Peripheral blood pressure (n = 71), no. (%)

Central blood pressure (n = 71), no. (%)

Agreement (kappa^b)

^aEarly OH: at 1 min of standing; OH: at 3 min of standing; delayed OH: at 6 min of standing; transient OH: at 1 or 3 or 6 min of standing; persistent OH: seen at 1, 3, and 6 min of standing. ^bFleiss’s guidelines (Fleiss et al, 2003) characterize kappa > 0.75 as excellent, 0.40 - 0.75 as good, < 0.40 as poor.

Early OH

12 (16.9%)

17 (23.9%)

0.70

19 (26.8%)

12 (16.9%)

0.72

Delayed OH

18 (25.4%)

14 (19.7%)

0.44

Transient OH

22 (31.0%)

19 (26.8%)

0.56

Persistent OH

11 (15.5%)

0.68

**Table 3.** Relationship Between Transient Orthostatic Hypotension (OH)^a, Cardiovascular and Fall-Related Outcomes by Peripheral and Central Blood Pressures
Variables	Transient OH
aOrthostatic hypotension as measured and present at 1 or 3 or 6 min of standing. †P < 0.05.
Central AP (%)	14.9 (9.0)	18.0 (9.3)	14.8 (9.0)	18.7 (9.0)
Central AI (%)	29.3 (11.7)	30.2 (11.0)	28.8 (11.3)	31.8 (11.9)
Symptoms of OH	21 (42.9%)	9 (40.9%)	25 (48.1%)	5 (26.3%)
History of OH	0 (0.0%)	1 (4.5%)	0 (0.0%)	1 (5.3%)
History of falls	18 (36.7%)	5 (22.7%)	21 (40.4%)	2 (10.5%)
Hypertension	33 (67.3%)	18 (81.8%)	34 (65.4%)	17 (89.5%)†
Coronary artery disease	8 (16.3%)	3 (13.6%)	8 (15.4%)	3 (15.8%)
Stroke	7 (14.3%)	2 (9.1%)	6 (11.5%)	3 (15.8%)
Heart failure	3 (6.1%)	1 (4.5%)	2 (3.8%)	2 (10.5%)
Type II diabetes	11 (22.4%)	6 (27.3%)	13 (25.0%)	4 (21.1%)
Dyslipidemia	15 (30.6%)	11 (50.0%)	15 (28.8%)	11 (57.9%)†
Peripheral vascular disease	4 (8.2%)	0 (0.0%)	2 (3.8%)	2 (10.5%)
CKD	1 (2.0%)	2 (9.1%)	1 (1.9%)	2 (10.5%)

Table 3. Relationship Between Transient Orthostatic Hypotension (OH)^a, Cardiovascular and Fall-Related Outcomes by Peripheral and Central Blood Pressures

Variables

Transient OH

Peripheral blood pressure, mean (SD) or no. (%)

Central blood pressure, mean (SD) or no. (%)

No (n = 49)

Yes (n = 22)

No (n = 52)

Yes (n = 19)

aOrthostatic hypotension as measured and present at 1 or 3 or 6 min of standing. †P < 0.05.

Central AP (%)

14.9 (9.0)

18.0 (9.3)

14.8 (9.0)

18.7 (9.0)

Central AI (%)

29.3 (11.7)

30.2 (11.0)

28.8 (11.3)

31.8 (11.9)

Symptoms of OH

21 (42.9%)

9 (40.9%)

25 (48.1%)

5 (26.3%)

History of OH

0 (0.0%)

1 (4.5%)

0 (0.0%)

1 (5.3%)

History of falls

18 (36.7%)

5 (22.7%)

21 (40.4%)

2 (10.5%)

Hypertension

33 (67.3%)

18 (81.8%)

34 (65.4%)

17 (89.5%)†

Coronary artery disease

8 (16.3%)

3 (13.6%)

8 (15.4%)

3 (15.8%)

Stroke

7 (14.3%)

2 (9.1%)

6 (11.5%)

3 (15.8%)

Heart failure

3 (6.1%)

1 (4.5%)

2 (3.8%)

2 (10.5%)

Type II diabetes

11 (22.4%)

6 (27.3%)

13 (25.0%)

4 (21.1%)

Dyslipidemia

15 (30.6%)

11 (50.0%)

15 (28.8%)

11 (57.9%)†

Peripheral vascular disease

4 (8.2%)

0 (0.0%)

2 (3.8%)

2 (10.5%)

CKD

1 (2.0%)

2 (9.1%)

1 (1.9%)

2 (10.5%)

**Table 4.** Relationship Between Persistent Orthostatic Hypotension (OH)^a, Cardiovascular and Fall-Related Outcomes by Peripheral and Central Blood Pressures
Variables	Persistent OH
^aOrthostatic hypotension as measured and present at 1, 3, and 6 min of standing. †P < 0.05.
Central AP (%)	15.2 (9.2)	19.5 (7.9)	14.8 (8.6)	22.2 (9.9)†
Central AI (%)	28.8 (11.3)	34.2 (11.7)	29.3 (11.7)	31.6 (10.0)
Symptoms of OH	25 (41.7%)	5 (45.5%)	25 (41.7%)	5 (45.5%)
History of OH	0 (0.0%)	1 (9.1%)	0 (0.0%)	1 (9.1%)
History of falls	21 (35.0%)	2 (18.2%)	21 (35.0%)	2 (18.2%)
Hypertension	41 (68.3%)	10 (90.9%)	41 (68.3%)	10 (90.9%)
Coronary artery disease	9 (15.0%)	2 (18.2%)	10 (16.7%)	1 (9.1%)
Stroke	7 (11.7%)	2 (18.2%)	8 (13.3%)	1 (9.1%)
Heart failure	4 (6.7%)	0 (0.0%)	3 (5.0%)	1 (9.1%)
Type II diabetes	14 (23.3%)	3 (27.3%)	14 (23.3%)	3 (27.3%)
Dyslipidemia	18 (30.0%)	8 (72.7%)†	19 (31.7%)	7 (63.6%)
Peripheral vascular disease	4 (6.7%)	0 (0.0%)	4 (6.7%)	0 (0.0%)
CKD	2 (3.3%)	1 (9.1%)	1 (1.7%)	2 (18.2%)

Table 4. Relationship Between Persistent Orthostatic Hypotension (OH)^a, Cardiovascular and Fall-Related Outcomes by Peripheral and Central Blood Pressures

Variables

Persistent OH

Peripheral blood pressure, mean (SD) or no. (%)

Central blood pressure, mean (SD) or no. (%)

No (n = 60)

Yes (n = 11)

No (n = 60)

Yes (n = 11)

^aOrthostatic hypotension as measured and present at 1, 3, and 6 min of standing. †P < 0.05.

Central AP (%)

15.2 (9.2)

19.5 (7.9)

14.8 (8.6)

22.2 (9.9)†

Central AI (%)

28.8 (11.3)

34.2 (11.7)

29.3 (11.7)

31.6 (10.0)

Symptoms of OH

25 (41.7%)

5 (45.5%)

25 (41.7%)

5 (45.5%)

History of OH

0 (0.0%)

1 (9.1%)

0 (0.0%)

1 (9.1%)

History of falls

21 (35.0%)

2 (18.2%)

21 (35.0%)

2 (18.2%)

Hypertension

41 (68.3%)

10 (90.9%)

41 (68.3%)

10 (90.9%)

Coronary artery disease

9 (15.0%)

2 (18.2%)

10 (16.7%)

1 (9.1%)

Stroke

7 (11.7%)

2 (18.2%)

8 (13.3%)

1 (9.1%)

Heart failure

4 (6.7%)

0 (0.0%)

3 (5.0%)

1 (9.1%)

Type II diabetes

14 (23.3%)

3 (27.3%)

14 (23.3%)

3 (27.3%)

Dyslipidemia

18 (30.0%)

8 (72.7%)†

19 (31.7%)

7 (63.6%)

Peripheral vascular disease

4 (6.7%)

0 (0.0%)

4 (6.7%)

0 (0.0%)

CKD

2 (3.3%)

1 (9.1%)

1 (1.7%)

2 (18.2%)