Related Experiment Video
Updated: May 8, 2026
14:09
Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Head turning-induced hypotension in elderly people
Yvonne Schoon1, Marcel G M Olde Rikkert, Sara Rongen
1Department of Geriatric Medicine Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. y.schoon@ger.umcn.nl
Plos One
|August 27, 2013
Summary
Head turning causes sudden blood pressure drops in elderly individuals with carotid sinus hypersensitivity, a condition linked to falls. This study confirms head movements as a significant trigger for hypotension in this population.
Area of Science:
- Geriatric Medicine
- Cardiovascular Physiology
- Neurology
Background:
- Carotid sinus hypersensitivity (CSH) is common in the elderly and a potential cause of falls.
- Head turning is suspected to trigger CSH by manipulating the carotid sinus, but direct evidence is limited.
Purpose of the Study:
- To investigate the direct effects of head turning on blood pressure and heart rate in elderly individuals with and without CSH.
- To determine if head turning is a significant trigger for hypotension in the elderly population.
Main Methods:
- Prospective observational study involving 105 elderly patients from a falls clinic and 25 healthy elderly controls.
- Continuous blood pressure and heart rate monitoring during and after head turning.
- Carotid sinus massage, active standing, and meal tests were used to assess CSH and other hypotensive syndromes.
Main Results:
- Head turning induced hypotension in 39% of patients and 44% of healthy elderly subjects.
- A significant association was found between CSH and head-turning induced hypotension (OR=3.5).
- Hypotension occurred irrespective of the direction of head movement.
Conclusions:
- Head turning is a significant trigger for sudden blood pressure drops in elderly individuals with carotid sinus hypersensitivity.
- These findings highlight the importance of considering head movements as a cause of falls in the elderly.
- Head turning-induced hypotension contributes to dizziness and syncope in susceptible individuals.
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:30Alterations in Blood Pressure
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
01:28Special considerations while measuring blood pressure
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.