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Risk Factors for Orthostatic Hypotension: Differences Between Elderly Men and Women.

Méndez AS, Melgarejo JD, Mena LJ, Chávez CA, González AC, Boggia J, Terwilliger JD, Lee JH, Maestre GE.

Am J Hypertens. 2018 Jun 11;31(7):797-803.

Andrea Méndez (Venezuela)

1) Summarize your work in one sentence.

-There has been controversial findings about how often men and women are affected by orthostatic hypotension that is, an excessive lowering of blood pressure when the person changes positions from supine to standing positions.  This controversy is even higher when we are talking about older adults.  

2) Summarize your findings in one sentence.

Older men and women have different risk factors for orthostatic hypotension.  Our results showed that high systolic blood pressure was an independent risk factor for orthostatic hypotension in women, but not in men. While body mass index, was associated with lower risk of orthostatic hypotension for both sexes.

3) Which were the more important methods you used in this work? If it is not a traditional method you can briefly explain the concept of that methodology.

We used a subset of 882 subjects 55 years of age or older, from the Maracaibo Aging Study, a longitudinal population-based study of Latin Americans.

To diagnose orthostatic hypotension, we used the strictest and most accepted diagnostic definition:  a reduction of >20 mmHg in the systolic blood pressure or >10 mmHg in the diastolic blood pressure, sustained both at 1 and 3 min after going from supine to standing positions.

To study if sex had a significant effect on the association between risk factors and orthostatic hypotension, we performed interaction term analysis using multivariate logistic regression models, accounting for the different characteristics of men and women.

4) What did you learn from this paper, what was your take-home message?

Orthostatic hypotension is very frequent both in older men and women. Prevalence of OH was generally constant and similar between younger men and women, but increased significantly in men and decreased in women older than 75 years.

As people age, there seems to be a relative importance of risk factors that is different from men than in women. Future studies need to address not only the mechanisms and treatments for orthostatic hypotension in elderly considering sex, but also this might be important to guide preventive measures.


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