Reproducibility of postural changes of blood pressure in hypertensive elderly patients in primary care

Abstract

OBJECTIVE: To determine the reproducibility of postural changes of blood pressure among hypertensive elderly patients in a primary care setting. METHODS: Measurements of blood pressure were carried out in 60 community-dwelling hypertensive patients aged 65 years or more, in a sitting position and after 1-min and 3-min standing, and were repeated not more than 10 days later. RESULTS: A significant (P<0.05) fall in systolic and diastolic sitting blood pressure was observed between the first visit (151.1+/-20.8/79.7+/-10.1 mmHg) and the second visit (143.5+/-20.6/76.8+/-10.9 mmHg). The intraclass correlation coefficients of the repeated measurements were 0.46 (CI: 0.23-0.65) and 0.42 (CI: 0.17-0.61) for the changes in systolic blood pressure after 1- and 3-min standing, and 0.55 (CI: 0.34-0.71) and 0.40 (CI: 0.16-0.60) for diastolic blood pressure after 1- and 3-min standing, respectively. The repeatability coefficients were greater for the orthostatic changes of blood pressure (54-65%), which indicates lower reproducibility, than for the blood pressure levels on both visits (31-44%). CONCLUSIONS: The reproducibility of the postural changes of blood pressure found in hypertensive elderly patients in primary care is poor. This should be taken into account when making diagnoses of orthostatic hypotension in this type of patient.