BLOOD PRESSURE VARIATIONS ASSOCIATED WITH AGEING IN SUB-SAHARAN AFRICA
DOI:
https://doi.org/10.46827/ejphs.v6i1.138Keywords:
blood pressure, ageing, orthostatic hypotension, symptomsAbstract
Elderly persons who live in communities and appear to be in good health frequently experience postural hypotension, which is frequently asymptomatic. Uncertainty exists regarding the relationship between postural changes in blood pressure and numerical factors including age, gender, and body mass index. The goal of the current study is to identify the orthostatic blood pressure (OBP) changing patterns, symptoms, and related factors in various age groups. In this study, sixty participants ranging in age from 20 to 75 years old were used. To check for orthostatic hypotension in these groups, various blood pressure readings are taken in the lying and standing positions at intervals of one minute and three minutes. The findings demonstrated that in the elderly groups, symptoms of headache, blurred vision, dizziness, and lightheadedness were unrelated to orthostatic hypotension. These subjects' Body Mass Indexes were calculated based on their nutritional condition, and they were found to be 60% well-nourished, 6% under-nourished, and 34% overweight. The elderly person had systolic hypotension (P<0.01) more frequently than diastolic hypotension (P>0.05). In the senior group, standing hypotension was equally common in both sexes. BMI declines with aging in males as well, n=60. In all four groups, heart rate readings in the standing position were greater than the supine measurement. In the older population of Ndola which was the subject group of the study, 16.7% had OH. Age and the decline in diastolic blood pressure after three minutes of standing were positively correlated in all males. In all females, a positive link was seen between body mass index and a reduction in diastolic blood pressure after three minutes of standing. After 3 minutes of standing, all males showed a positive link between body mass index and a decrease in systolic blood pressure. Therefore, there is a link between body mass index and a drop in blood pressure readings when standing. On the basis of the current study, we draw the conclusion that orthostatic hypotension rises with age and that symptoms are unrelated to physical measurements.References
Adiyaman A, Verhoeff R, Lenders JW, Deinum J and Thien T. The position of the arm during blood pressure measurement in sitting position. Blood Press Monit. 2006; 11: 309-13.
Akselrod S, Oz O, Greenberg M and Keselbrener L. Autonomic response to the change of posture among normal and mild hypertensive adults: investigation by time-dependent spectral analysis. J Auton Nerv Syst. 1997; 64: 33-43.
Baccarelli, Helen Suh, Robert O., Wright, David Sparrow, Pantel Vokonas, and Joel Crow, R. S., Lohman, M. C., Titus, A. J., Bruce, M. L., Mackenzie, T. A., Bartels, S. J., & Batsis, J. A. (2018). Mortality risk along the frailty spectrum: data from the National Health and Nutrition Examination Survey 1999 to 2004. Journal of the American Geriatrics Society, 66(3), 496-502.
Elissa Wilker, Murray A. Mittleman, Augusto A. Litonjua, Audrey Poon, Andrea Fagard, R. H., & De Cort, P. (2010). Orthostatic hypotension is a more robust predictor of cardiovascular events than nighttime reverse dipping in elderly. Hypertension, 56(1), 56-61.
Fedorowski, A., Engström, G., Hedblad, B., & Melander, O. (2010). Orthostatic hypotension predicts incidence of heart failure: the Malmö preventive project. American journal of hypertension, 23(11), 1209-1215.
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., ... & Van Dijk, J. G. (2011). Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Autonomic Neuroscience: Basic and Clinical, 161(1), 46-48.
Fu, Q., Okazaki, K., Shibata, S., Shook, R. P., VanGunday, T. B., Galbreath, M. M., ... & Levine, B. D. (2009). Menstrual cycle effects on sympathetic neural responses to upright tilt. The Journal of physiology, 587(9), 2019-2031.
Gibbons, C. H., Schmidt, P., Biaggioni, I., Frazier-Mills, C., Freeman, R., Isaacson, S., ... & Kaufmann, H. (2017). The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. Journal of neurology, 264(8), 1567-1582.
Grote, K., Drexler, H., & Schieffer, B. (2004). Renin–angiotensin system and atherosclerosis. Nephrology Dialysis Transplantation, 19(4), 770-773.
Gupta D and Nair MD. Neurogenic orthostatic hypotension: chasing "the fall".
Postgrad Med J. 2008; 84: 6-14.
Gupta, V., & Lipsitz, L. A. (2007). Orthostatic hypotension in the elderly: diagnosis and treatment. The American journal of medicine, 120(10), 841-847.
Hajjar I. Postural blood pressure changes and orthostatic hypotension in the elderly
patient: impact of antihypertensive medications. Drugs Aging. 2005; 22: 55-68.
Harris T, Lipsitz LA, Kleinman JC and Cornoni-Huntley J. Postural change in blood
pressure associated with age and systolic blood pressure. The National Health and Nutrition Examination Survey II. J Gerontol. 1991; 46: 159-163.
Island, T. StatPearls Publishing; 2020 Jan.
Kamaruzzaman, S., Watt, H., Carson, C., & Ebrahim, S. (2010). The association between orthostatic hypotension and medication use in the British Women’s Heart and Health Study. Age and ageing, 39(1), 51-56.
Kanjwal, K., George, A., Figueredo, V. M., & Grubb, B. P. (2015). Orthostatic hypotension: definition, diagnosis, and management. Journal of cardiovascular medicine, 16(2), 75-81.
Li L, Li H, He L, Chen H, Li Y. Study on the relationship between orthostatic hypotension and heart rate variability, pulse wave velocity index, and frailty index in the elderly: a retrospective observational study. Frontiers in cardiovascular medicine. 2020 Nov 27;7:603957.
Low, P. A. (2008). Prevalence of orthostatic hypotension. Clinical Autonomic Research, 18(1), 8-13.
Luukinen H, Koski K, Laippala P and Kivelä SL. Prognosis of diastolic and
systolic orthostatic hypotension in older patients. Arch Intern Med. 1999; 159:273-
Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., ... & Zannad, F. (2014). 2013 ESH/ESC practice guidelines for the management of arterial hypertension: ESH-ESC the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Blood pressure, 23(1), 3-16.
Mattace-Raso, F. U., van der Cammen, T. J., Knetsch, A. M., van den Meiracker, A. H., Schalekamp, M. A., Hofman, A., & Witteman, J. C. (2006). Arterial stiffness as the candidate underlying mechanism for postural blood pressure changes and orthostatic hypotension in older adults: the Rotterdam Study. Journal of hypertension, 24(2), 339-344.
Ooi WL, Barrett S, Hossain M, KelleyGagnon M and Lipsitz LA. Patterns of
orthostatic blood pressure change and their clinical correlates in a frail, elderly
population. JAMA.1997; 277:1299-1304.
Perlmuter, L. C., & Greenberg, J. J. (1996). Do you mind standing?: cognitive changes in orthostasis. Experimental aging research, 22(4), 325-341.
Ricci, F., De Caterina, R., & Fedorowski, A. (2015a). Orthostatic hypotension: epidemiology, prognosis, and treatment. Journal of the American College of Cardiology, 66(7), 848-860.
Ricci, F., Fedorowski, A., Radico, F., Romanello, M., Tatasciore, A., Di Nicola, M., ... & De Caterina, R. (2015b). Cardiovascular morbidity and mortality related to orthostatic hypotension: a meta-analysis of prospective observational studies. European heart journal, 36(25), 1609-1617.
Richardson, J., Kerr, S. R., Shaw, F., Kenny, R. A., O'Brien, J. T., & Thomas, A. J. (2009). A study of orthostatic hypotension in late-life depression. The American Journal of Geriatric Psychiatry, 17(11), 996-999.
Romero-Vecchione, E., Wessolosky, M., Lupi, J., Vasquez, J., Velasco, M., & Gomez, J. (1993). Changes produced by age in cardiovascular reflex responses. Investigacion Clinica, 34(4), 193-208.
Rose, K. M., Eigenbrodt, M. L., Biga, R. L., Couper, D. J., Light, K. C., Sharrett, A. R., & Heiss, G. (2006). Orthostatic hypotension predicts mortality in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Circulation, 114(7), 630-636.
Rutan GH, Hermanson B, Bild DE, Kittner SJ, LaBaw F and Tell GS. Orthostatic
hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group. Hypertension. 1992; 19: 508-519.
Schatz, I. J., Bannister, R., Freeman, R. L., Jankovic, J., Koller, W. C., Low, P. A., ... & Streeten, D. H. P. (1996). Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy. Clinical Autonomic Research, 6(2), 125-126.
Schroeder, C., Tank, J., Boschmann, M., Diedrich, A., Sharma, A. M., Biaggioni, I., ... & Jordan, J. (2002). Selective norepinephrine reuptake inhibition as a human model of orthostatic intolerance. Circulation, 105(3), 347-353.
Schwartz. Postural Changes in Blood Pressure Associated with Interactions between Candidate Genes for Chronic Respiratory Diseases and Exposure to Particulate Matter. Envir Healt Persp. 2009; 117: 935-940.
Shibao, C., Lipsitz, L. A., & Biaggioni, I. (2013). ASH position paper: evaluation and treatment of orthostatic hypotension. The Journal of Clinical Hypertension, 15(3), 147-153.
Shin C, Abbott RD, Lee H, Kim J and Kimm K. Prevalence and correlates of orthostatic
hypotension in middle-aged men and women in Korea: the Korean Health and Genome
Study. J Hum Hypertens 2004; 18:717-723.
Vuvor F. Correlation of body mass index and blood pressure of adults of 30–50 years of age in Ghana. J Health Res Rev 2017;4:115-21
Weiss A, Grossman E, Beloosesky Y and Grinblat J. Orthostatic hypotension in acute
geriatric ward: is it a consistent finding? Arch Intern Med. 2002; 162: 2369-2374.
Xin, W., Lin, Z., & Mi, S. (2014). Orthostatic hypotension and mortality risk: a meta-analysis of cohort studies. Heart, 100(5), 406-413.
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