BP variability in old elderly

1
BP variability in old elderly

• Limited research available
• Variability of BP increases in older people due
  to arterial and cardiac stiffness
• Impairment of arterial and cardiopulmonary
  baroreflexes
• SBP varies greatly while diastolic is relatively
  fixed

2
Orthostatic hypotension

• Orthostatic hypotension (OH) supine standing
  SBP gt 20 mmHg
• OH is a major risk factor
• CVD rates increase dramatically (up to 4x)
• Stroke rates are greater in OH (up to 2x)
• Falls, hip fractures add other morbidity/mortality
  
• Symptoms are common, can be disabling

3
Other forms of hypotension

• Increased white matter lesions on MRI in
• Exaggerated nighttime dippers
• Post-prandial hypotension
• Post-exercise hypotension also reported to be
  more common in elderly
• All forms of hypotension exacerbated by volume
  depletion (diuretic)