“Elderly people whose blood pressure rises when they wake up are more frail”

A study found that elderly people with orthostatic hypertension, which causes blood pressure to rise when standing up from lying down, are more frail than those without the condition.

Senility refers to a state in which the physiological functions that maintain the body’s homeostasis decline, causing various diseases to occur, and the risk of hospitalization and death increases. It is a different concept from aging, which refers to symptoms that inevitably occur as one grows older.

The research team led by Professors Kim Gwang-il and Choi Jeong-yeon of the Department of Geriatrics at Seoul National University Bundang Hospital and Professor Ryu Dong-yeol of Kangwon National University Hospital conducted an orthostatic blood pressure fluctuation test on 2,065 elderly hypertensive patients recruited from 12 national university hospitals in Korea. They then conducted a study to identify the relationship between blood pressure fluctuations upon standing and △ frailty △ cognitive decline △ deterioration in quality of life.

When you lie down and get up, your blood pressure usually drops slightly. On the other hand, if your blood pressure rises, it can be considered a relatively worse state of health.

The analysis results showed that 4.6% of elderly hypertensive patients had orthostatic hypertension, and 4.1% had orthostatic hypotension (lowering blood pressure when standing up). When combined, the proportion of patients with orthostatic blood pressure fluctuations was approximately 9% of the total.

The research team confirmed that the rate of frailty was higher in hypertensive patients with orthostatic hypertension. In elderly hypertensive patients with normal blood pressure fluctuations when standing, the pre-frailty rate was 23% and the frailty rate was 4%, while in patients with orthostatic hypertension, the pre-frailty rate was 38% and the frailty rate was 8%, which was significantly higher than in the control group.

In addition, patients with orthostatic hypertension showed lower scores in cognitive function evaluations, confirming that this is related to cognitive decline such as dementia. In the quality of life evaluation questionnaire, it was confirmed that the scores were lower than those of the control group in items such as △maintaining daily activities △exercise ability △pain △discomfort.

Professor Kim Gwang-il said, “Considering the current domestic situation where we are on the verge of entering a super-aged society, the number of elderly patients with hypertension is expected to increase rapidly in the future.” He added, “As we have discovered a close correlation between orthostatic blood pressure changes, aging, and cognitive decline among elderly patients with hypertension, it is necessary to establish an optimal blood pressure management strategy that suits the characteristics of each patient.”

The results of this study were published in Hypertension, the official journal of the American Heart Association.