Associations between orthostatic hypotension and related factors in hospitalised older adults: a cross-sectional study in Turkey

Orthostatic hypotension is a prevalent condition in older adults. In light of its potential association with serious complications, the routine assessment of orthostatic blood pressure changes and the evaluation of factors associated with orthostatic hypotension in hospitalised older adults remain of current importance. Raising awareness among nurses, who are healthcare professionals closely involved in patient care, on this issue is essential. To investigate the prevalence of orthostatic hypotension and its associated factors in hospitalised older adults. This analytical cross-sectional study was conducted using a questionnaire and blood pressure measurements. Data were collected from 265 older adults hospitalised in the internal medicine clinics of a state hospital. Descriptive statistics and parametric and non-parametric tests were used for data analysis. Binary logistic regression analysis was performed for further evaluation. Orthostatic hypotension was assessed using the supine-to-standing test; when this was not feasible, the sit-to-stand test was used. Orthostatic hypotension was observed in 14.3% of the participants. Chronic kidney disease, regular medication use, and diuretic use appeared to be more common among participants with orthostatic hypotension. Participants who reported leg pain while standing were significantly associated with orthostatic hypotension (OR = 2.51; 95% CI: 1.24–5.05; p = 0.010). A statistically non-significant but increasing trend was observed in the association between regular medication use and orthostatic hypotension (OR = 3.21; 95% CI: 0.95–10.89; p = 0.061). A 1-mmHg increase in systolic blood pressure in the supine/sitting position was associated with orthostatic hypotension (OR = 1.08; p < 0.001), whereas higher systolic blood pressure measured at 3 min of standing was associated with a lower prevalence of orthostatic hypotension (OR = 0.91; p < 0.001). Orthostatic hypotension was observed in approximately one out of every seven older adults. Older adults who report leg pain while standing at any time of day may be more likely to have orthostatic hypotension. Healthcare professionals should consider that orthostatic hypotension may still occur in individuals with higher systolic blood pressure in the supine position. Our findings may support the importance of assessing orthostatic hypotension using the supine-to-standing test, unless there is any factor that would prevent the test from being performed.