Blood pressure associates with standing balance in elderly outpatients

Jantsje H Pasma, Astrid Y Bijlsma, Janneke M Klip, Marjon Stijntjes, Gerard Jan Blauw, Majon Muller, Carel G M Meskers, Andrea B Maier

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

OBJECTIVES: Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment.

MATERIALS AND METHODS: In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197) and continuously (subsample, n = 58) before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1) the ability to maintain standing balance; 2) self-reported impaired standing balance; and 3) history of falls, adjusted for age and sex.

RESULTS: Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements.

CONCLUSION: Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care.

Original languageEnglish
Pages (from-to)e106808
JournalPLoS ONE
Volume9
Issue number9
DOIs
Publication statusPublished - 2014

Fingerprint

Blood pressure
blood pressure
Outpatients
Blood Pressure
Geriatrics
eyes
Pressure measurement
Posture
Pressure regulation
Geriatric Assessment
Independent Living
Orthostatic Hypotension
hypotension
Supine Position
Proxy
Ambulatory Care Facilities
cohort studies
Teaching Hospitals
Logistics
Teaching

Keywords

  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Outpatients
  • Postural Balance

Cite this

Pasma, J. H., Bijlsma, A. Y., Klip, J. M., Stijntjes, M., Blauw, G. J., Muller, M., ... Maier, A. B. (2014). Blood pressure associates with standing balance in elderly outpatients. PLoS ONE, 9(9), e106808. https://doi.org/10.1371/journal.pone.0106808
Pasma, Jantsje H ; Bijlsma, Astrid Y ; Klip, Janneke M ; Stijntjes, Marjon ; Blauw, Gerard Jan ; Muller, Majon ; Meskers, Carel G M ; Maier, Andrea B. / Blood pressure associates with standing balance in elderly outpatients. In: PLoS ONE. 2014 ; Vol. 9, No. 9. pp. e106808.
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abstract = "OBJECTIVES: Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment.MATERIALS AND METHODS: In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197) and continuously (subsample, n = 58) before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1) the ability to maintain standing balance; 2) self-reported impaired standing balance; and 3) history of falls, adjusted for age and sex.RESULTS: Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements.CONCLUSION: Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care.",
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Pasma, JH, Bijlsma, AY, Klip, JM, Stijntjes, M, Blauw, GJ, Muller, M, Meskers, CGM & Maier, AB 2014, 'Blood pressure associates with standing balance in elderly outpatients' PLoS ONE, vol. 9, no. 9, pp. e106808. https://doi.org/10.1371/journal.pone.0106808

Blood pressure associates with standing balance in elderly outpatients. / Pasma, Jantsje H; Bijlsma, Astrid Y; Klip, Janneke M; Stijntjes, Marjon; Blauw, Gerard Jan; Muller, Majon; Meskers, Carel G M; Maier, Andrea B.

In: PLoS ONE, Vol. 9, No. 9, 2014, p. e106808.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Blood pressure associates with standing balance in elderly outpatients

AU - Pasma, Jantsje H

AU - Bijlsma, Astrid Y

AU - Klip, Janneke M

AU - Stijntjes, Marjon

AU - Blauw, Gerard Jan

AU - Muller, Majon

AU - Meskers, Carel G M

AU - Maier, Andrea B

PY - 2014

Y1 - 2014

N2 - OBJECTIVES: Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment.MATERIALS AND METHODS: In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197) and continuously (subsample, n = 58) before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1) the ability to maintain standing balance; 2) self-reported impaired standing balance; and 3) history of falls, adjusted for age and sex.RESULTS: Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements.CONCLUSION: Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care.

AB - OBJECTIVES: Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment.MATERIALS AND METHODS: In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197) and continuously (subsample, n = 58) before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1) the ability to maintain standing balance; 2) self-reported impaired standing balance; and 3) history of falls, adjusted for age and sex.RESULTS: Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements.CONCLUSION: Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care.

KW - Aged

KW - Aged, 80 and over

KW - Blood Pressure

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KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Male

KW - Outpatients

KW - Postural Balance

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Pasma JH, Bijlsma AY, Klip JM, Stijntjes M, Blauw GJ, Muller M et al. Blood pressure associates with standing balance in elderly outpatients. PLoS ONE. 2014;9(9):e106808. https://doi.org/10.1371/journal.pone.0106808