Original Paper Received: February 19, 2014 Accepted: September 21, 2014 Published online: December 16, 2014
Neuroepidemiology 2014;43:239–243 DOI: 10.1159/000368699
Head-Up Tilt Testing for Detecting Orthostatic Hypotension: How Long Do We Need to Wait? Tanya Gurevich a, b Hanadi Machmid c Dina Klepikov a Adi Ezra a Nir Giladi a–c Chava Peretz d
a
Movement Disorders Unit and Neuroautonomic service, Department of Neurology, Tel-Aviv Sourasky Medical Center, b Sackler Faculty of Medicine, Tel-Aviv University, c School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, and d Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
Abstract Background: Orthostatic hypotension (OH) is a common underdiagnosed condition characterized by a fall in systolic or diastolic blood pressure (BP). There is some uncertainty about the minimum duration needed to detect OH beyond 3 min (delayed OH). We aimed to define a minimum time range for measurement of delayed OH in subjects referred to as tilt testing. Methods: A repeated measurements study Tel-Aviv Medical Center, on 692 subjects who underwent prolonged (40 min, vertical position) drug-free tilt testing. Survival curves were used to study time to an OH event; logistic regression to study factors associated with delayed OH and mixed models to study the pattern of repeated BP measures. Results: In our sample, 17% had OH within 3 min, 35% within 30 min, and 40% within 40 min. Among the 270
© 2014 S. Karger AG, Basel 0251–5350/14/0434–0239$39.50/0 E-Mail [email protected] www.karger.com/ned
OH patients, 43 and 91% were identified within 3 and 30 min, respectively. Delayed OH was associated with female gender (OR = 1.95, 1.16–3.27) and age
Neuroepidemiology 2014;43:239–243 DOI: 10.1159/000368699
Head-Up Tilt Testing for Detecting Orthostatic Hypotension: How Long Do We Need to Wait? Tanya Gurevich a, b Hanadi Machmid c Dina Klepikov a Adi Ezra a Nir Giladi a–c Chava Peretz d
a
Movement Disorders Unit and Neuroautonomic service, Department of Neurology, Tel-Aviv Sourasky Medical Center, b Sackler Faculty of Medicine, Tel-Aviv University, c School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, and d Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
Abstract Background: Orthostatic hypotension (OH) is a common underdiagnosed condition characterized by a fall in systolic or diastolic blood pressure (BP). There is some uncertainty about the minimum duration needed to detect OH beyond 3 min (delayed OH). We aimed to define a minimum time range for measurement of delayed OH in subjects referred to as tilt testing. Methods: A repeated measurements study Tel-Aviv Medical Center, on 692 subjects who underwent prolonged (40 min, vertical position) drug-free tilt testing. Survival curves were used to study time to an OH event; logistic regression to study factors associated with delayed OH and mixed models to study the pattern of repeated BP measures. Results: In our sample, 17% had OH within 3 min, 35% within 30 min, and 40% within 40 min. Among the 270
© 2014 S. Karger AG, Basel 0251–5350/14/0434–0239$39.50/0 E-Mail [email protected] www.karger.com/ned
OH patients, 43 and 91% were identified within 3 and 30 min, respectively. Delayed OH was associated with female gender (OR = 1.95, 1.16–3.27) and age
