Orthostatic Blood Pressure Recovery Measured Using a Sphygmomanometer Is Not Associated with Physical Performance or Number of Falls in Geriatric Outpatients

Background: Orthostatic hypotension (OH) and impaired OH recovery derived from beat-to-beat blood pressure (BP) measurements are associated with detrimental clinical outcome, but the clinical relevance of OH recovery assessed using the widely available sphygmomanometer is still unclear. Method: 635 geriatric outpatients underwent comprehensive geriatric assessment, including orthostatic BP measurements using a sphygmomanometer, during supine rest and 1 and 3 min after standing up and assessment of physical performance (i.e., the timed up and go test and the Short Physical Performance Battery) and the number of falls in the past year. The association between BP recovery, defined as BP at 3 min minus BP at 1 min after standing up, with physical performance and falls was assessed using regression analyses, adjusting for age and sex, both in the entire cohort and after stratifying for the presence of OH at 1 min after standing up. Results: BP recovery was not associated with physical performance or number of falls, neither in the entire cohort, nor in subpopulations with or without OH. Conclusion: The clinical relevance of BP recovery between 1 and 3 min after standing up could not be demonstrated. The results suggest that sphygmomanometer measurements have an inadequate time resolution to record the clinically relevant dynamics of orthostatic BP recovery.

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785 Reported Restful Sleep Predicting Emotional Distress: Does Exercise (and its modalities) moderate?

SLEEP ◽

10.1093/sleep/zsab072.782 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A305-A306

Author(s):

Jesse Moore ◽

Ellita Williams ◽

Collin Popp ◽

Anthony Briggs ◽

Judite Blanc ◽

...

Keyword(s):

Logistic Regression ◽

Aerobic Exercise ◽

Regression Models ◽

Regression Analyses ◽

Logistic Regression Models ◽

The Past ◽

Strengthening Exercise ◽

Waking Up ◽

The Relationship ◽

Age And Sex

Abstract Introduction Literature shows that exercise moderates the relationship between sleep and emotional distress (ED.) However, it is unclear whether different types of exercise, such as aerobic and strengthening, affect this relationship differently. We investigated the moderating role of two types of exercise (aerobic and strengthening) regarding the relationship between ED and sleep. Methods Our analysis was based on data from 2018 National Health Interview Survey (NHIS), a nationally representative study in which 2,814 participants provided all data. Participants were asked 1) “how many days they woke up feeling rested over the past week”, 2) the Kessler 6 scale to determine ED (a score >13 indicates ED), and 3) the average frequency of strengthening or aerobic exercise per week. Logistic regression analyses were performed to determine if the reported days of waking up rested predicted level of ED. We then investigated whether strengthening or aerobic exercise differentially moderated this relationship. Covariates such as age and sex were adjusted in the logistic regression models. Logistic regression analyses were performed to determine if subjective reporting of restful sleep predicted level of ED. We investigated whether strengthening exercise or aerobic exercise differentially moderated this relationship. Covariates such as age and sex were adjusted in the logistic regression models. Results On average, participants reported 4.41 restful nights of sleep (SD =2.41), 3.43 strengthening activities (SD = 3.19,) and 8.47 aerobic activities a week (SD=5.91.) We found a significant association between days over the past week reporting waking up feeling rested and ED outcome according to K6, Χ2(1) = -741, p= <.001. The odds ratio signified a decrease of 52% in ED scores for each unit of restful sleep (OR = .48, (95% CI = .33, .65) p=<.001.) In the logistic regression model with moderation, aerobic exercise had a significant moderation effect, Χ2(1) = .03, p=.04, but strengthening exercise did not. Conclusion We found that restful sleep predicted reduction in ED scores. Aerobic exercise moderated this relationship, while strengthening exercise did not. Further research should investigate the longitudinal effects of exercise type on the relationship between restful sleep and ED. Support (if any) NIH (K07AG052685, R01MD007716, K01HL135452, R01HL152453)

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Orthostatic blood pressure recovery associates with physical performance, frailty and number of falls in geriatric outpatients

Journal of Hypertension ◽

10.1097/hjh.0000000000002617 ◽

2020 ◽

Vol 39 (1) ◽

pp. 101-106

Author(s):

Arjen Mol ◽

Lois R.N. Slangen ◽

Richard J.A. van Wezel ◽

Andrea B. Maier ◽

Carel G.M. Meskers

Keyword(s):

Blood Pressure ◽

Physical Performance ◽

Pressure Recovery ◽

Orthostatic Blood Pressure

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Association of blood pressure and postural control in older adults with hypertension: an observational study

Comparative Exercise Physiology ◽

10.3920/cep210016 ◽

2021 ◽

pp. 1-8

Author(s):

P. Sharma ◽

S. Parveen ◽

S. Masood ◽

M.M. Noohu

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Stability Index ◽

Balance Performance ◽

Position Change ◽

Timed Up And Go ◽

Balance System ◽

Eyes Closed ◽

Standing Up ◽

Functional Position

The study investigated the association of orthostatic hypotension (OH) with functional position change and balance in older adults with hypertension. The presence of OH was assessed with intermittent (OH intermittent) and continuous blood pressure (OH continuous) monitoring. The change in functional position was tested with sitting to standing assessment, balance performance using activity specific balance confidence scale (ABC), and timed up and go test (TUG). Testing unilateral and bilateral standing with and without altered sensory inputs was tested using the Humac balance system. ABC, TUG, and standing up time showed no significant association with OH intermittent and OH continuous. A significant association was found between bilateral standing with eyes closed on foam surface for overall stability index and OH intermittent. Older people with hypertension may be routinely examined for OH and appropriate intervention strategies should be included for comprehensive care.

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Relationship Between Orthostatic Blood Pressure Changes and Postural Sway When Standing up from a Chair in Older Adult Females

International Journal of Gerontology ◽

10.1016/j.ijge.2012.01.011 ◽

2012 ◽

Vol 6 (3) ◽

pp. 182-186 ◽

Cited By ~ 7

Author(s):

Jun Murata ◽

Shin Murata ◽

Jun Horie ◽

Hiroshi Ohtao ◽

Junya Miyazaki

Keyword(s):

Blood Pressure ◽

Older Adult ◽

Postural Sway ◽

Adult Females ◽

Orthostatic Blood Pressure ◽

Standing Up ◽

Pressure Changes

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Effect of time standing up on orthostatic blood pressure change in the elderly: The J-SHIPP Study

Geriatrics and Gerontology International ◽

10.1111/j.1447-0594.2005.00316.x ◽

2005 ◽

Vol 5 (4) ◽

pp. 254-258 ◽

Cited By ~ 1

Author(s):

Yasuharu Tabara ◽

Katsuhiko Kohara ◽

Toshie Azechi ◽

Michie Ohnishi ◽

Shouzoh Ueki ◽

...

Keyword(s):

Blood Pressure ◽

Pressure Change ◽

The Elderly ◽

Blood Pressure Change ◽

Orthostatic Blood Pressure ◽

Standing Up

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Improving physical performance through independent, home-based exercise program prior to cancer-related surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.27_suppl.54 ◽

2019 ◽

Vol 37 (27_suppl) ◽

pp. 54-54

Author(s):

Rhodora C. Fontillas ◽

An Ngo-Huang ◽

Amy Ng ◽

Roan Asumbrado ◽

Betty Holder ◽

...

Keyword(s):

Physical Therapy ◽

Physical Performance ◽

Exercise Program ◽

Stressful Event ◽

Timed Up And Go ◽

Oncologic Surgery ◽

Entire Cohort ◽

Home Based ◽

6Mwt Distance

54 Background: Surgery in older adults is a physiologically stressful event associated with reduced functional capacity and decreased quality of life. Poor preoperative performance is linked to risk of postoperative complications and prolonged functional recovery. The goal of this study is to determine the efficacy of an independent, home-based exercise program in improving physical performance prior to cancer-related surgery. Methods: Retrospective study of 217 consecutive patients referred for comprehensive prehabilitation including physical medicine and rehabilitation physician and physical therapy visits prior to intended oncologic surgery. Physical performance was assessed at consultation (baseline) and at the preoperative follow up visit in physical therapy. Physical performance measures included Six-Minute Walk test (6MWT), Five Times Sit to Stand (5xSTS), hand grip strength (HGS), gait speed (GS), and Timed Up and Go (TUG). Results: Median (IQR) age was 71 (64,77). The most common primary cancer diagnoses were gastrointestinal (43%), genitourinary (15%), breast (9%), and sarcoma (7%). 144 of the 217 (66%) underwent surgery and of these, 75 (52%) completed preoperative functional measures during their physical therapy follow-up. For the entire cohort of 217 patients, baseline median (IQR) measures included: 6MWT distance was 357 (193.3, 420) meters, 5xSTS was 12 (9.1, 16.3) seconds, right HGS was 43.3 (30.0, 58.3) pounds, GS was 1.4 (1, 1.7) meters per second, and TUG was 8.6 (7.3, 12.2) seconds. There were similar baseline physical function results in the cohort who completed preoperative measures. During the preoperative period (from baseline to pre-surgery visit), there was significant improvement in the 6MWT ( P=0.003), 5xSTS ( P=0.000), and TUG ( P=0.027). There was no significant change in HGS or GS. Conclusions: At baseline, most patients had major functional impairment, especially decreased submaximal exercise capacity. With the independent, home-based exercise prehabilitation program, patients had significant improvement in physical performance. Prehabilitation should be further investigated in these patients.

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