Abstract
The object of this study was to examine blood pressure (BP) variability due to postural change in elderly hypertensive patients. The subjects studied were 154 elderly inpatients in a hospital for the elderly (48 male and 106 female; median age: 82 years), consisting of age- and sex-matched bedridden (n=39) and non-bedridden (n=39) normotensive controls and bedridden (n=38) and non-bedridden (n=38) hypertensive patients. BP and pulse rate (PR) were measured in the supine position, then again after a 2-min, 45 deg head-up tilt with the legs horizontal. The decrease in systolic BP (SBP) on tilting in the bedridden hypertensive group (median: −10 mmHg; range: −32 to 9 mmHg) was significantly (p<0.008) greater than those in the other three groups. Monotherapy with azelnidipine, a long-acting calcium channel blocker, for 3 months not only significantly reduced the basal BP and PR of hypertensive patients in the two groups, but also significantly (p<0.05) attenuated the tilt-induced decrease in the SBP to −3 mmHg (−19 to 25 mmHg) and enhanced the change in PR from −1 bpm (−10 to 7 bpm) to 1 bpm (−4 to 23 bpm) in the bedridden hypertensive group. Our findings indicate that tilt-induced decrease in SBP is a rather common phenomenon in bedridden elderly hypertensive patients, and that treatment with azelnidipine attenuates tilt-induced decrease in SBP, probably through an improvement of baroreceptor sensitivity.
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Morimoto, S., Takahashi, T., Okaishi, K. et al. Tilting-Induced Decrease in Systolic Blood Pressure in Bedridden Hypertensive Elderly Inpatients: Effects of Azelnidipine. Hypertens Res 29, 943–949 (2006). https://doi.org/10.1291/hypres.29.943
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DOI: https://doi.org/10.1291/hypres.29.943
