Predictors of orthostatic hypotension in patients attending a transient ischaemic attack clinic: database study

Beatriz de la Iglesia, Alice C L Ong, John F Potter, Anthony K Metcalf, Phyo Kyaw Myint

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background. Orthostatic hypotension (OH) is common amongst the older population and is associated with morbidity and mortality. We sought to investigate predictors of OH to assist the clinician in identifying patients at risk. Methods and results. Database of 2696 patients attending a transient ischaemic attack (TIA) clinic between January 2006 and May 2009 was examined. Logistic regression models were constructed to determine clinical associates of OH. Demographics, co-morbidities, cardiovascular risk factors and medications were included in the multivariate models. Simple data mining models in the form of rule sets were developed for each component and they were assessed for predictive accuracy. The best models were validated on a smaller sample. Prevalence of OH was 22.3% in the TIA clinic population (50.6% men, mean 72 years; 49.4% women, mean 75 years). A significant postural drop in systolic blood pressure (BP) (≥ 20 mmHg) was more prevalent than a significant diastolic BP drop (≥ 10 mmHg). Isolated systolic hypertension was common (52.4%). Common factors predicting a significant systolic and diastolic BP fall were older age, previous TIA, being a current smoker, having diabetes and the use of beta-blockers. Both mean arterial and pulse pressure (MAP and PP) derived from supine BP were significantly associated with OH. Conclusions. OH should be assessed routinely in TIA clinics. MAP and PP may provide information on the predictability of OH.
Original languageEnglish
Pages (from-to)120-127
Number of pages8
JournalBlood Pressure
Volume22
Issue number2
DOIs
Publication statusPublished - Apr 2013

Fingerprint

Orthostatic Hypotension
Transient Ischemic Attack
Databases
Blood Pressure
Logistic Models
Morbidity
Data Mining
Population
Arterial Pressure
Demography
Hypertension
Mortality

Keywords

  • adrenergic beta-antagonists
  • age factors
  • aged
  • aged, 80 and over
  • arterial pressure
  • diabetes complications
  • diabetes mellitus
  • diastole
  • female
  • heart rate
  • humans
  • hypertension
  • hypotension, orthostatic
  • ischemic attack, transient
  • male
  • middle aged
  • multivariate analysis
  • retrospective studies
  • risk factors
  • smoking
  • systole
  • blood pressure
  • epidemiology
  • orthostatic hypertension
  • predictors

Cite this

Predictors of orthostatic hypotension in patients attending a transient ischaemic attack clinic : database study. / de la Iglesia, Beatriz; Ong, Alice C L; Potter, John F; Metcalf, Anthony K; Myint, Phyo Kyaw.

In: Blood Pressure, Vol. 22, No. 2, 04.2013, p. 120-127.

Research output: Contribution to journalArticle

de la Iglesia, Beatriz ; Ong, Alice C L ; Potter, John F ; Metcalf, Anthony K ; Myint, Phyo Kyaw. / Predictors of orthostatic hypotension in patients attending a transient ischaemic attack clinic : database study. In: Blood Pressure. 2013 ; Vol. 22, No. 2. pp. 120-127.
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abstract = "Background. Orthostatic hypotension (OH) is common amongst the older population and is associated with morbidity and mortality. We sought to investigate predictors of OH to assist the clinician in identifying patients at risk. Methods and results. Database of 2696 patients attending a transient ischaemic attack (TIA) clinic between January 2006 and May 2009 was examined. Logistic regression models were constructed to determine clinical associates of OH. Demographics, co-morbidities, cardiovascular risk factors and medications were included in the multivariate models. Simple data mining models in the form of rule sets were developed for each component and they were assessed for predictive accuracy. The best models were validated on a smaller sample. Prevalence of OH was 22.3{\%} in the TIA clinic population (50.6{\%} men, mean 72 years; 49.4{\%} women, mean 75 years). A significant postural drop in systolic blood pressure (BP) (≥ 20 mmHg) was more prevalent than a significant diastolic BP drop (≥ 10 mmHg). Isolated systolic hypertension was common (52.4{\%}). Common factors predicting a significant systolic and diastolic BP fall were older age, previous TIA, being a current smoker, having diabetes and the use of beta-blockers. Both mean arterial and pulse pressure (MAP and PP) derived from supine BP were significantly associated with OH. Conclusions. OH should be assessed routinely in TIA clinics. MAP and PP may provide information on the predictability of OH.",
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N2 - Background. Orthostatic hypotension (OH) is common amongst the older population and is associated with morbidity and mortality. We sought to investigate predictors of OH to assist the clinician in identifying patients at risk. Methods and results. Database of 2696 patients attending a transient ischaemic attack (TIA) clinic between January 2006 and May 2009 was examined. Logistic regression models were constructed to determine clinical associates of OH. Demographics, co-morbidities, cardiovascular risk factors and medications were included in the multivariate models. Simple data mining models in the form of rule sets were developed for each component and they were assessed for predictive accuracy. The best models were validated on a smaller sample. Prevalence of OH was 22.3% in the TIA clinic population (50.6% men, mean 72 years; 49.4% women, mean 75 years). A significant postural drop in systolic blood pressure (BP) (≥ 20 mmHg) was more prevalent than a significant diastolic BP drop (≥ 10 mmHg). Isolated systolic hypertension was common (52.4%). Common factors predicting a significant systolic and diastolic BP fall were older age, previous TIA, being a current smoker, having diabetes and the use of beta-blockers. Both mean arterial and pulse pressure (MAP and PP) derived from supine BP were significantly associated with OH. Conclusions. OH should be assessed routinely in TIA clinics. MAP and PP may provide information on the predictability of OH.

AB - Background. Orthostatic hypotension (OH) is common amongst the older population and is associated with morbidity and mortality. We sought to investigate predictors of OH to assist the clinician in identifying patients at risk. Methods and results. Database of 2696 patients attending a transient ischaemic attack (TIA) clinic between January 2006 and May 2009 was examined. Logistic regression models were constructed to determine clinical associates of OH. Demographics, co-morbidities, cardiovascular risk factors and medications were included in the multivariate models. Simple data mining models in the form of rule sets were developed for each component and they were assessed for predictive accuracy. The best models were validated on a smaller sample. Prevalence of OH was 22.3% in the TIA clinic population (50.6% men, mean 72 years; 49.4% women, mean 75 years). A significant postural drop in systolic blood pressure (BP) (≥ 20 mmHg) was more prevalent than a significant diastolic BP drop (≥ 10 mmHg). Isolated systolic hypertension was common (52.4%). Common factors predicting a significant systolic and diastolic BP fall were older age, previous TIA, being a current smoker, having diabetes and the use of beta-blockers. Both mean arterial and pulse pressure (MAP and PP) derived from supine BP were significantly associated with OH. Conclusions. OH should be assessed routinely in TIA clinics. MAP and PP may provide information on the predictability of OH.

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