Skip to main content
Top
Published in: BMC Geriatrics 1/2018

Open Access 01-12-2018 | Research Article

Blood pressure change does not associate with Center of Pressure movement after postural transition in geriatric outpatients

Authors: Sjoerd T. Timmermans, Esmee M. Reijnierse, Jantsje H. Pasma, Marijke C. Trappenburg, Gerard J. Blauw, Andrea B. Maier, Carel G. M. Meskers

Published in: BMC Geriatrics | Issue 1/2018

Login to get access

Abstract

Background

Orthostatic hypotension (OH), a blood pressure drop after postural change, is associated with impaired standing balance and falls in older adults. This study aimed to assess the association between blood pressure (BP) and a measure of quality of standing balance, i.e. Center of Pressure (CoP) movement, after postural change from supine to standing position in geriatric outpatients, and to compare CoP movement between patients with and without OH.

Methods

In a random subgroup of 75 consecutive patients who were referred to a geriatric outpatient clinic, intermittent BP measurements were obtained simultaneously with CoP measurements in mediolateral and anterior-posterior direction directly after postural change during 3 min of quiet stance with eyes open on a force plate. Additional measurements of continuous BP were available in n = 38 patients. Associations between BP change during postural change and CoP movement were analyzed using Spearman correlation. Mann-Whitney-U tests were used to compare CoP movement between patients with OH and without OH, in which OH was defined as a BP drop exceeding 20 mmHg of systolic BP (SBP) and/or 10 mmHg of diastolic BP (DBP) within 3 min after postural change.

Results

OH measured intermittently was found in 8 out of 75 (11%) and OH measured continuously in 22 out of 38 patients (57.9%). BP change did not associate with CoP movement. CoP movement did not differ significantly between patients with and without OH.

Conclusions

Results do not underpin the added value of CoP movement measurements in diagnosing OH in a clinical setting. Neither could we identify the role of CoP measurements in the understanding of the relation between OH and impaired standing balance.
Appendix
Available only for authorised users
Literature
1.
go back to reference Jonsson R, Sixt E, Landahl S, Rosenhall U. Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res. 2004;14(1):47–52.PubMed Jonsson R, Sixt E, Landahl S, Rosenhall U. Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res. 2004;14(1):47–52.PubMed
2.
go back to reference Lin HW, Bhattacharyya N. Balance disorders in the elderly: epidemiology and functional impact. Laryngoscope. 2012;122(8):1858–61.CrossRefPubMed Lin HW, Bhattacharyya N. Balance disorders in the elderly: epidemiology and functional impact. Laryngoscope. 2012;122(8):1858–61.CrossRefPubMed
4.
go back to reference Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35(Suppl 2):ii37–41.CrossRefPubMed Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35(Suppl 2):ii37–41.CrossRefPubMed
5.
go back to reference Sturnieks DL, St GR, Lord SR. Balance disorders in the elderly. Neurophysiol Clin. 2008;38(6):467–78.CrossRefPubMed Sturnieks DL, St GR, Lord SR. Balance disorders in the elderly. Neurophysiol Clin. 2008;38(6):467–78.CrossRefPubMed
6.
go back to reference Shaw BH, Claydon VE. The relationship between orthostatic hypotension and falling in older adults. Clin Auton Res. 2014;24(1):3–13.CrossRefPubMed Shaw BH, Claydon VE. The relationship between orthostatic hypotension and falling in older adults. Clin Auton Res. 2014;24(1):3–13.CrossRefPubMed
7.
go back to reference Pasma JH, Engelhart D, Schouten AC, van der Kooij H, Maier AB, Meskers CG. Impaired standing balance: the clinical need for closing the loop. Neuroscience. 2014;267:157–65.CrossRefPubMed Pasma JH, Engelhart D, Schouten AC, van der Kooij H, Maier AB, Meskers CG. Impaired standing balance: the clinical need for closing the loop. Neuroscience. 2014;267:157–65.CrossRefPubMed
8.
go back to reference Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: a review. Neurobiol Aging. 1989;10(6):727–38.CrossRefPubMed Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: a review. Neurobiol Aging. 1989;10(6):727–38.CrossRefPubMed
9.
go back to reference Muir JW, Kiel DP, Hannan M, Magaziner J, Rubin CT. Dynamic parameters of balance which correlate to elderly persons with a history of falls. PLoS One. 2013;8(8):e70566.CrossRefPubMedPubMedCentral Muir JW, Kiel DP, Hannan M, Magaziner J, Rubin CT. Dynamic parameters of balance which correlate to elderly persons with a history of falls. PLoS One. 2013;8(8):e70566.CrossRefPubMedPubMedCentral
10.
go back to reference Gray-Miceli D, Ratcliffe SJ, Thomasson A, Quigley P, Li K, Craelius W. Clinical risk factors for orthostatic hypotension: results among elderly fallers in long-term care. J Patient Saf. 2016. Epub ahead of print. Gray-Miceli D, Ratcliffe SJ, Thomasson A, Quigley P, Li K, Craelius W. Clinical risk factors for orthostatic hypotension: results among elderly fallers in long-term care. J Patient Saf. 2016. Epub ahead of print.
11.
go back to reference Shen S, He T, Chu J, He J, Chen X. Uncontrolled hypertension and orthostatic hypotension in relation to standing balance in elderly hypertensive patients. Clin Interv Aging. 2015;10:897–906.CrossRefPubMedPubMedCentral Shen S, He T, Chu J, He J, Chen X. Uncontrolled hypertension and orthostatic hypotension in relation to standing balance in elderly hypertensive patients. Clin Interv Aging. 2015;10:897–906.CrossRefPubMedPubMedCentral
12.
go back to reference Gangavati A, Hajjar I, Quach L, Jones RN, Kiely DK, Gagnon P, Lipsitz LA. Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. J Am Geriatr Soc. 2011;59(3):383–9.CrossRefPubMedPubMedCentral Gangavati A, Hajjar I, Quach L, Jones RN, Kiely DK, Gagnon P, Lipsitz LA. Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. J Am Geriatr Soc. 2011;59(3):383–9.CrossRefPubMedPubMedCentral
13.
go back to reference Heitterachi E, Lord SR, Meyerkort P, McCloskey I, Fitzpatrick R. Blood pressure changes on upright tilting predict falls in older people. Age Ageing. 2002;31(3):181–6.CrossRefPubMed Heitterachi E, Lord SR, Meyerkort P, McCloskey I, Fitzpatrick R. Blood pressure changes on upright tilting predict falls in older people. Age Ageing. 2002;31(3):181–6.CrossRefPubMed
14.
go back to reference Romero-Ortuno R, Cogan L, Foran T, Kenny RA, Fan CW. Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people. J Am Geriatr Soc. 2011;59(4):655–65.CrossRefPubMed Romero-Ortuno R, Cogan L, Foran T, Kenny RA, Fan CW. Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people. J Am Geriatr Soc. 2011;59(4):655–65.CrossRefPubMed
15.
go back to reference Kaufmann H. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy. Clin Auton Res. 1996;6(2):125–6.CrossRefPubMed Kaufmann H. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy. Clin Auton Res. 1996;6(2):125–6.CrossRefPubMed
16.
go back to reference Wieling W, Krediet CT, van Dijk N, Linzer M, Tschakovsky ME. Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (Lond). 2007;112(3):157–65. Wieling W, Krediet CT, van Dijk N, Linzer M, Tschakovsky ME. Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (Lond). 2007;112(3):157–65.
17.
18.
go back to reference Rutan GH, Hermanson B, Bild DE, Kittner SJ, LaBaw F, Tell GS. Orthostatic hypotension in older adults. The cardiovascular health study. CHS collaborative research group. Hypertension. 1992;19(6 Pt 1):508–19.CrossRefPubMed Rutan GH, Hermanson B, Bild DE, Kittner SJ, LaBaw F, Tell GS. Orthostatic hypotension in older adults. The cardiovascular health study. CHS collaborative research group. Hypertension. 1992;19(6 Pt 1):508–19.CrossRefPubMed
19.
go back to reference Fedorowski A, Stavenow L, Hedblad B, Berglund G, Nilsson PM, Melander O. Orthostatic hypotension predicts all-cause mortality and coronary events in middle-aged individuals (the Malmo preventive project). Eur Heart J. 2010;31(1):85–91.CrossRefPubMed Fedorowski A, Stavenow L, Hedblad B, Berglund G, Nilsson PM, Melander O. Orthostatic hypotension predicts all-cause mortality and coronary events in middle-aged individuals (the Malmo preventive project). Eur Heart J. 2010;31(1):85–91.CrossRefPubMed
20.
go back to reference Pasma JH, Bijlsma AY, Klip JM, Stijntjes M, Blauw GJ, Muller M, Meskers CG, Maier AB. Blood pressure associates with standing balance in elderly outpatients. PLoS One. 2014;9(9):e106808.CrossRefPubMedPubMedCentral Pasma JH, Bijlsma AY, Klip JM, Stijntjes M, Blauw GJ, Muller M, Meskers CG, Maier AB. Blood pressure associates with standing balance in elderly outpatients. PLoS One. 2014;9(9):e106808.CrossRefPubMedPubMedCentral
21.
go back to reference Matinolli M, Korpelainen JT, Korpelainen R, Sotaniemi KA, Myllyla VV. Orthostatic hypotension, balance and falls in Parkinson's disease. Mov Disord. 2009;24(5):745–51.CrossRefPubMed Matinolli M, Korpelainen JT, Korpelainen R, Sotaniemi KA, Myllyla VV. Orthostatic hypotension, balance and falls in Parkinson's disease. Mov Disord. 2009;24(5):745–51.CrossRefPubMed
22.
go back to reference Pasma JH, Bijlsma AY, van der Bij MD, Arendzen JH, Meskers CG, Maier AB. Age-related differences in quality of standing balance using a composite score. Gerontology. 2014;60(4):306–14.CrossRefPubMed Pasma JH, Bijlsma AY, van der Bij MD, Arendzen JH, Meskers CG, Maier AB. Age-related differences in quality of standing balance using a composite score. Gerontology. 2014;60(4):306–14.CrossRefPubMed
23.
go back to reference Stijntjes M, Pasma JH, van Vuuren M, Blauw GJ, Meskers CG, Maier AB. Low cognitive status is associated with a lower ability to maintain standing balance in elderly outpatients. Gerontology. 2015;61(2):124–30.CrossRefPubMed Stijntjes M, Pasma JH, van Vuuren M, Blauw GJ, Meskers CG, Maier AB. Low cognitive status is associated with a lower ability to maintain standing balance in elderly outpatients. Gerontology. 2015;61(2):124–30.CrossRefPubMed
24.
go back to reference Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMed
25.
go back to reference Reijnierse EM, de Jong N, Trappenburg MC, Blauw GJ, Butler-Browne G, Gapeyeva H, Hogrel JY, McPhee JS, Narici MV, Sipila S, et al. Assessment of maximal handgrip strength: how many attempts are needed? J Cachexia Sarcopenia Muscle. 2017;8(3):466–74.CrossRefPubMedPubMedCentral Reijnierse EM, de Jong N, Trappenburg MC, Blauw GJ, Butler-Browne G, Gapeyeva H, Hogrel JY, McPhee JS, Narici MV, Sipila S, et al. Assessment of maximal handgrip strength: how many attempts are needed? J Cachexia Sarcopenia Muscle. 2017;8(3):466–74.CrossRefPubMedPubMedCentral
26.
go back to reference Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–94.CrossRefPubMed Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–94.CrossRefPubMed
27.
go back to reference Imholz BP, Wieling W, van Montfrans GA, Wesseling KH. Fifteen years experience with finger arterial pressure monitoring: assessment of the technology. Cardiovasc Res. 1998;38(3):605–16.CrossRefPubMed Imholz BP, Wieling W, van Montfrans GA, Wesseling KH. Fifteen years experience with finger arterial pressure monitoring: assessment of the technology. Cardiovasc Res. 1998;38(3):605–16.CrossRefPubMed
28.
go back to reference van der Velde N, van den Meiracker AH, Stricker BH, van der Cammen TJ. Measuring orthostatic hypotension with the Finometer device: is a blood pressure drop of one heartbeat clinically relevant? Blood Press Monit. 2007;12(3):167–71.CrossRefPubMed van der Velde N, van den Meiracker AH, Stricker BH, van der Cammen TJ. Measuring orthostatic hypotension with the Finometer device: is a blood pressure drop of one heartbeat clinically relevant? Blood Press Monit. 2007;12(3):167–71.CrossRefPubMed
29.
go back to reference Prieto TE, Myklebust JB, Hoffmann RG, Lovett EG, Myklebust BM. Measures of postural steadiness: differences between healthy young and elderly adults. IEEE Trans Biomed Eng. 1996;43(9):956–66.CrossRefPubMed Prieto TE, Myklebust JB, Hoffmann RG, Lovett EG, Myklebust BM. Measures of postural steadiness: differences between healthy young and elderly adults. IEEE Trans Biomed Eng. 1996;43(9):956–66.CrossRefPubMed
30.
go back to reference Johnson CB, Mihalko SL, Newell KM. Aging and the time needed to reacquire postural stability. J Aging Physical Activity. 2003;11(4):459–69.CrossRef Johnson CB, Mihalko SL, Newell KM. Aging and the time needed to reacquire postural stability. J Aging Physical Activity. 2003;11(4):459–69.CrossRef
31.
go back to reference Visser JE, Carpenter MG, van der Kooij H, Bloem BR. The clinical utility of posturography. Clin Neurophysiol. 2008;119(11):2424–36.CrossRefPubMed Visser JE, Carpenter MG, van der Kooij H, Bloem BR. The clinical utility of posturography. Clin Neurophysiol. 2008;119(11):2424–36.CrossRefPubMed
32.
go back to reference Novak V, Novak P, Spies JM, Low PA. Autoregulation of cerebral blood flow in orthostatic hypotension. Stroke. 1998;29(1):104–11.CrossRefPubMed Novak V, Novak P, Spies JM, Low PA. Autoregulation of cerebral blood flow in orthostatic hypotension. Stroke. 1998;29(1):104–11.CrossRefPubMed
33.
go back to reference Novak V, Haertle M, Zhao P, Hu K, Munshi M, Novak P, Abduljalil A, Alsop D. White matter hyperintensities and dynamics of postural control. Magn Reson Imaging. 2009;27(6):752–9.CrossRefPubMedPubMedCentral Novak V, Haertle M, Zhao P, Hu K, Munshi M, Novak P, Abduljalil A, Alsop D. White matter hyperintensities and dynamics of postural control. Magn Reson Imaging. 2009;27(6):752–9.CrossRefPubMedPubMedCentral
34.
go back to reference Rickards CA, Cohen KD, Bergeron LL, Burton BL, Khatri PJ, Lee CT, Ryan KL, Cooke WH, Doerr DF, Convertino VA. Cerebral blood flow response and its association with symptoms during orthostatic hypotension. Aviat Space Environ Med. 2007;78(7):653–8.PubMed Rickards CA, Cohen KD, Bergeron LL, Burton BL, Khatri PJ, Lee CT, Ryan KL, Cooke WH, Doerr DF, Convertino VA. Cerebral blood flow response and its association with symptoms during orthostatic hypotension. Aviat Space Environ Med. 2007;78(7):653–8.PubMed
35.
go back to reference Perlmuter LC, Sarda G, Casavant V, Mosnaim AD. A review of the etiology, associated comorbidities, and treatment of orthostatic hypotension. Am J Ther. 2013;20(3):279–91.CrossRefPubMed Perlmuter LC, Sarda G, Casavant V, Mosnaim AD. A review of the etiology, associated comorbidities, and treatment of orthostatic hypotension. Am J Ther. 2013;20(3):279–91.CrossRefPubMed
36.
go back to reference Paulson OB, Strandgaard S, Edvinsson L. Cerebral autoregulation. Cerebrovasc Brain Metab Rev. 1990;2(2):161–92.PubMed Paulson OB, Strandgaard S, Edvinsson L. Cerebral autoregulation. Cerebrovasc Brain Metab Rev. 1990;2(2):161–92.PubMed
37.
go back to reference Brooke-Wavell K, Perrett LK, Howarth PA, Haslam RA. Influence of the visual environment on the postural stability in healthy older women. Gerontology. 2002;48(5):293–7.CrossRefPubMed Brooke-Wavell K, Perrett LK, Howarth PA, Haslam RA. Influence of the visual environment on the postural stability in healthy older women. Gerontology. 2002;48(5):293–7.CrossRefPubMed
38.
go back to reference Lord SR, Rogers MW, Howland A, Fitzpatrick R. Lateral stability, sensorimotor function and falls in older people. J Am Geriatr Soc. 1999;47(9):1077–81.CrossRefPubMed Lord SR, Rogers MW, Howland A, Fitzpatrick R. Lateral stability, sensorimotor function and falls in older people. J Am Geriatr Soc. 1999;47(9):1077–81.CrossRefPubMed
Metadata
Title
Blood pressure change does not associate with Center of Pressure movement after postural transition in geriatric outpatients
Authors
Sjoerd T. Timmermans
Esmee M. Reijnierse
Jantsje H. Pasma
Marijke C. Trappenburg
Gerard J. Blauw
Andrea B. Maier
Carel G. M. Meskers
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2018
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0702-2

Other articles of this Issue 1/2018

BMC Geriatrics 1/2018 Go to the issue