The Degree and Timing of Orthostatic Blood Pressure Changes in Relation to Falls in Nursing Home Residents

2004 ◽  
Vol 5 (4) ◽  
pp. 233-238
Author(s):  
Mathew S. Maurer ◽  
Samantha Cohen ◽  
Huai Cheng
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bistra I. Veleva ◽  
Monique A. A. Caljouw ◽  
Astrid Muurman ◽  
Jenny T. van der Steen ◽  
Victor G. M. Chel ◽  
...  

Abstract Background Observational studies have reported an inverse association between ultraviolet (UV) radiation and hypertension. The aim of this study was to assess differences in blood pressure changes between persons with dementia receiving UV light versus vitamin D (VD) supplementation. Methods Post-hoc analysis of randomized controlled trial data concerning nursing home residents with dementia (N = 61; 41 women, mean age 84.8 years). The participants received half-body UV irradiation, twice weekly over 6 months, at one standard erythema dose (UV group, n = 22) or 5600 international units of cholecalciferol once a week (VD group, n = 39). Short-term effects were evaluated after 1 month and long-term effects after 3 and 6 months. Differences in blood pressure changes were assessed using linear mixed models. Results With the VD group as a reference, the estimated difference in mean change of systolic blood pressure was − 26.0 mmHg [95% confidence interval (CI) -39.9, − 12.1, p = .000] at 1 month, 4.5 mmHg (95% CI -6.8, 15.9, p = 0.432) at 3 months, and 0.1 (95% CI -14.1, 14.3, p = 0.83) at 6 months. The estimated difference in diastolic blood pressure was − 10.0 mmHg (95% CI -19.2, − 0.7, p = 0.035) at 1 month, 3.6 mmHg (95% CI -4.1, 11.2, p = 0.358) at 3 months, and 2.7 (95% CI -6.8, 12.1, p = 0.580) at 6 months. Conclusions UV light had only a short-term effect but not a long-term effect on blood pressure reduction compared to VD use in this sample of normotensive to mild hypertensive nursing home residents with dementia. Future studies will be needed to determine the effect of UV light in different samples of the population and especially in a population with hypertension.


2021 ◽  
Author(s):  
Haekyung Jeon‐Slaughter ◽  
Lucile Parker Gregg ◽  
Michael Concepcion ◽  
Swati Lederer ◽  
Jeffrey Penfield ◽  
...  

2019 ◽  
Vol 30 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Nor Izzati Saedon ◽  
◽  
James Frith ◽  
Choon-Hian Goh ◽  
Wan Azman Wan Ahmad ◽  
...  

1997 ◽  
Vol 6 (6) ◽  
pp. 343-348 ◽  
Author(s):  
Martin Fotherby ◽  
Pervaiz Iqbal ◽  
John Potter

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 138-138
Author(s):  
Laura A Graham ◽  
Sei Lee ◽  
Michael Steinman ◽  
Carmen Peralta ◽  
Anna Rubinsky ◽  
...  

Abstract Blood pressure (BP) is a complex dynamic system in the human body and an important determinant of healthy aging. Exploring BP as a dynamic data system may provide important insights into how BP patterns can provide complementary information to the static, one-time BP measurements that are more commonly used for clinical decision making. Thus, we sought to describe BP as a dynamic data system in older adults nearing death. Using a prospective cohort study design, we assessed BP measures 6 months before death in Veterans Health Administrative nursing home residents between 10/1/2006 and 9/30/2017. Variability was characterized using standard deviation and mean square error after adjusting for diurnal variations. Complexity (i.e., amount of novel information vs. redundancy) was examined using Shannon’s entropy (bits). Generalized linear models were used to examine factors associated with overall BP variability. We identified 17,953 patients (98.0% male, 82.5% White, mean age 80.2 years, and mean BP 125.7/68.6 mmHg). In the last 6 months of life, systolic BP decreased slightly (⃞-7.2mmHg). Variability was stable until the last month of life, at which point variability increased by as much as 30%. In contrast, complexity did not change in the 6 months before death (⃞0.02 bits). Factors associated with BP variability before death include hospitalizations, hospice care, and medication changes. Systolic BP decreases in the last 6 months before death, and BP variability increases in the last month of life. Further, the increase in BP variability may be driven by increasingly complex care patterns as one approaches death.


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