P29 | Orthostatic hypotension in hypertensive patients hospitalized in Internal Medicine: baseline results of IpOp study
R. Buso1, C. Ferri2, A. Mazza3, A. Moggi Pignone4, F. Dentali5, M. D’Avino6, S. Maule7, M. Rattazzi1, P. Minuz8, D. Manfellotto9 | 1Ospedale Cà Foncello, Università degli Studi di Padova, Dipartimento di Medicina, DIMED, Medicina Interna 1, Treviso, 2University of L’Aquila, MeSVA Department, San Salvatore Hospital, UOC of Internal Medicine and Nephrology, 3ESH Excellence Hypertension Centre and Dept. of Internal Medicine, Santa Maria Regina degli Angeli General Hospital, Adria (RO), AULSS 5 Polesana, 4Azienda Ospedaliera-Universitaria Careggi, Firenze Dipartimento di Medicina Clinica e Sperimentale, SOD complessa di Medicina Interna 4, 5Università dell’Insubria, Dipartimento di Area Medica, Asst Sette Laghi, Medicina Generale, Varese, 6Ospedale Cardarelli, Napoli, 7Ospedale “Città della Salute”, Torino, 8UOC General Medicine C, Department of Medicine, AOUI Verona and University of Verona, 9Internal Medicine Department, Isola Tiberina Hospital Gemelli Isola, Rome, Italy
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Background: Orthostatic hypotension (OH) is defined as a sustained reduction in systolic blood pressure of at least 20 mmHg or a reduction in diastolic blood pressure of at least 10 mmHg, usually within the first 3 minutes of standing.
Aim: To evaluate the prevalence of OH and associated comorbidities in hypertensive patients hospitalized in Internal Medicine Units.
Materials and Methods: An Italian observational, multicenter, prospective study (IpOp study) included 1000 hypertensive patients hospitalized in 29 Units of Internal Medicine and followed for 36 months. Demographic and clinical data, blood pressure measures and blood tests were recorded at baseline.
Results: The overall prevalence of OH in our study was 25.1%. Syncope was associated with OH (RR 1.76; 95%CI 1.19-2.60; p=0.005), while other symptoms were not. Parkinson’s disease (RR 3.72; 95%CI 2.42-5.72; p<0.0001), type 1 diabetes mellitus (RR 2.24; 95%CI 1.28-3.93; p=0.005) and α2-blocker drugs (RR 1.52; 95%CI 1.13-2.04; p=0.006) were associated with OH. Respiratory comorbidities resulted associated with OH (RR 1.52; 95%CI 1.10-2.09; p=0.01), whereas cardiovascular disease, anemia, chronic kidney disease and other antihypertensive drugs, cognitive impairment and frailty were not.
Conclusions: The IpOp study confirms the association between OH and syncope, Parkinson’s disease, type 1 diabetes mellitus and use of α2 antagonists. Moreover, also respiratory comorbidities were associated with OH. The follow-up reporting the onset of new falls, major cardiovascular events and deaths is still ongoing.
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