Postural hypotension in elderly family practice patients

Postural hypotension (PH) was investigated in 100 ambulatory patients aged 65 years or older, who were seen in a university family practice clinic. Thirty-one percent had a decrease in systolic blood pressure of 20 mmHg or more, while 16 percent had a diastolic drop of 10 mmHg or more. Twelve percent had a significant drop in both systolic and diastolic blood pressure upon standing. Patients with both systolic and diastolic PH were more likely to have had a fall during the year prior to evaluation and decreased functional ability compared with those without PH. The group with systolic PH was more likely to have symptoms on standing and a history of weakness, but dizziness and lightheadedness were not correlated with PH. Postural hypotension occurred in only 13 percent of patients without risk factors for PH and in 35 percent of patients with risk factors. However, this difference was not statistically significant. Demographics and functional ability were similar between the risk factor groups. Thus, PH occurred frequently in our patients, could not be reliably predicted on the basis of risk factors or symptoms, and was correlated with a history of a recent fall and decreased functional ability.