Lower standing systolic blood pressure as a predictor of falls in the elderly

A community-based prospective study

Kazuomi Kario, Jonathan N. Tobin, Leslie I. Wolfson, Robert Whipple, Carol A. Derby, Devender Singh, Paul R. Marantz, Sylvia Wassertheil-Smoller

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

OBJECTIVES. We investigated prospectively the relationships among falls, physical balance, and standing and supine blood pressure (BP) in elderly persons. BACKGROUND. Falls occur often and adversely affect the activities of daily living in the elderly; however, their relationship to BP has not been clarified thoroughly. METHODS. A total of 266 community-dwelling elderly persons age 65 years or over (123 men and 143 women, mean age of 76 years) were selected from among residents of Coop City, Bronx, New York. Balance was evaluated at baseline using computerized dynamic posturography (DPG). During a one-year follow-up, we collected information on subsequent falls on a monthly basis by postcard and telephone follow-up. RESULTS. One or more falls occurred in 60 subjects (22%) during the one-year follow-up. Women fell more frequently than men (28% vs. 16%, p < 0.03), and fallers were younger than nonfallers. Fallers (n = 60) had lower systolic BP (SBP) levels when compared with nonfallers (n = 206) (128 ± 17 vs. 137 ± 22 mm Hg for standing, p < 0.006; 137 ± 16 vs. 144 ± 22 mm Hg for lying, p < 0.02), whereas diastolic BP was not related to falls. Falls occurred 2.8 times more often in the lower BP subgroup (<140 mm Hg for standing SBP) than in the higher BP subgroup (≥140 mm Hg, p < 0.0003), and gender-related differences were observed (p = 0.006): 3.4 times for women (p < 0.0001) versus 1.9 times for men (p = 0.30). Loss of balance, as detected by DPG, did not predict future fills and was also not associated with baseline BP levels. Multiple logistic regression analysis demonstrated that female gender (relative risk [RR] = 2.1, p = 0.02), history of falls (RR = 2.5, p = 0.008) and lower standing SBP level (RR = 0.78 for 10 mm Hg increase, p = 0.005) were independent predictors of falls during one year of follow-up. CONCLUSIONS. Lower standing SBP, even within normotensive ranges, was an independent predictor of falls in the community-dwelling elderly. Elderly women with a history of falls and with lower SBP levels should have more attention paid to the prevention of falls and related accidents.

Original languageEnglish (US)
Pages (from-to)246-252
Number of pages7
JournalJournal of the American College of Cardiology
Volume38
Issue number1
DOIs
StatePublished - 2001

Fingerprint

Prospective Studies
Blood Pressure
Independent Living
Activities of Daily Living
Telephone
Accidents
Logistic Models
Regression Analysis
Hypertension

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Lower standing systolic blood pressure as a predictor of falls in the elderly : A community-based prospective study. / Kario, Kazuomi; Tobin, Jonathan N.; Wolfson, Leslie I.; Whipple, Robert; Derby, Carol A.; Singh, Devender; Marantz, Paul R.; Wassertheil-Smoller, Sylvia.

In: Journal of the American College of Cardiology, Vol. 38, No. 1, 2001, p. 246-252.

Research output: Contribution to journalArticle

Kario, Kazuomi ; Tobin, Jonathan N. ; Wolfson, Leslie I. ; Whipple, Robert ; Derby, Carol A. ; Singh, Devender ; Marantz, Paul R. ; Wassertheil-Smoller, Sylvia. / Lower standing systolic blood pressure as a predictor of falls in the elderly : A community-based prospective study. In: Journal of the American College of Cardiology. 2001 ; Vol. 38, No. 1. pp. 246-252.
@article{42b0af2936c1418d8d500815211e7948,
title = "Lower standing systolic blood pressure as a predictor of falls in the elderly: A community-based prospective study",
abstract = "OBJECTIVES. We investigated prospectively the relationships among falls, physical balance, and standing and supine blood pressure (BP) in elderly persons. BACKGROUND. Falls occur often and adversely affect the activities of daily living in the elderly; however, their relationship to BP has not been clarified thoroughly. METHODS. A total of 266 community-dwelling elderly persons age 65 years or over (123 men and 143 women, mean age of 76 years) were selected from among residents of Coop City, Bronx, New York. Balance was evaluated at baseline using computerized dynamic posturography (DPG). During a one-year follow-up, we collected information on subsequent falls on a monthly basis by postcard and telephone follow-up. RESULTS. One or more falls occurred in 60 subjects (22{\%}) during the one-year follow-up. Women fell more frequently than men (28{\%} vs. 16{\%}, p < 0.03), and fallers were younger than nonfallers. Fallers (n = 60) had lower systolic BP (SBP) levels when compared with nonfallers (n = 206) (128 ± 17 vs. 137 ± 22 mm Hg for standing, p < 0.006; 137 ± 16 vs. 144 ± 22 mm Hg for lying, p < 0.02), whereas diastolic BP was not related to falls. Falls occurred 2.8 times more often in the lower BP subgroup (<140 mm Hg for standing SBP) than in the higher BP subgroup (≥140 mm Hg, p < 0.0003), and gender-related differences were observed (p = 0.006): 3.4 times for women (p < 0.0001) versus 1.9 times for men (p = 0.30). Loss of balance, as detected by DPG, did not predict future fills and was also not associated with baseline BP levels. Multiple logistic regression analysis demonstrated that female gender (relative risk [RR] = 2.1, p = 0.02), history of falls (RR = 2.5, p = 0.008) and lower standing SBP level (RR = 0.78 for 10 mm Hg increase, p = 0.005) were independent predictors of falls during one year of follow-up. CONCLUSIONS. Lower standing SBP, even within normotensive ranges, was an independent predictor of falls in the community-dwelling elderly. Elderly women with a history of falls and with lower SBP levels should have more attention paid to the prevention of falls and related accidents.",
author = "Kazuomi Kario and Tobin, {Jonathan N.} and Wolfson, {Leslie I.} and Robert Whipple and Derby, {Carol A.} and Devender Singh and Marantz, {Paul R.} and Sylvia Wassertheil-Smoller",
year = "2001",
doi = "10.1016/S0735-1097(01)01327-4",
language = "English (US)",
volume = "38",
pages = "246--252",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "1",

}

TY - JOUR

T1 - Lower standing systolic blood pressure as a predictor of falls in the elderly

T2 - A community-based prospective study

AU - Kario, Kazuomi

AU - Tobin, Jonathan N.

AU - Wolfson, Leslie I.

AU - Whipple, Robert

AU - Derby, Carol A.

AU - Singh, Devender

AU - Marantz, Paul R.

AU - Wassertheil-Smoller, Sylvia

PY - 2001

Y1 - 2001

N2 - OBJECTIVES. We investigated prospectively the relationships among falls, physical balance, and standing and supine blood pressure (BP) in elderly persons. BACKGROUND. Falls occur often and adversely affect the activities of daily living in the elderly; however, their relationship to BP has not been clarified thoroughly. METHODS. A total of 266 community-dwelling elderly persons age 65 years or over (123 men and 143 women, mean age of 76 years) were selected from among residents of Coop City, Bronx, New York. Balance was evaluated at baseline using computerized dynamic posturography (DPG). During a one-year follow-up, we collected information on subsequent falls on a monthly basis by postcard and telephone follow-up. RESULTS. One or more falls occurred in 60 subjects (22%) during the one-year follow-up. Women fell more frequently than men (28% vs. 16%, p < 0.03), and fallers were younger than nonfallers. Fallers (n = 60) had lower systolic BP (SBP) levels when compared with nonfallers (n = 206) (128 ± 17 vs. 137 ± 22 mm Hg for standing, p < 0.006; 137 ± 16 vs. 144 ± 22 mm Hg for lying, p < 0.02), whereas diastolic BP was not related to falls. Falls occurred 2.8 times more often in the lower BP subgroup (<140 mm Hg for standing SBP) than in the higher BP subgroup (≥140 mm Hg, p < 0.0003), and gender-related differences were observed (p = 0.006): 3.4 times for women (p < 0.0001) versus 1.9 times for men (p = 0.30). Loss of balance, as detected by DPG, did not predict future fills and was also not associated with baseline BP levels. Multiple logistic regression analysis demonstrated that female gender (relative risk [RR] = 2.1, p = 0.02), history of falls (RR = 2.5, p = 0.008) and lower standing SBP level (RR = 0.78 for 10 mm Hg increase, p = 0.005) were independent predictors of falls during one year of follow-up. CONCLUSIONS. Lower standing SBP, even within normotensive ranges, was an independent predictor of falls in the community-dwelling elderly. Elderly women with a history of falls and with lower SBP levels should have more attention paid to the prevention of falls and related accidents.

AB - OBJECTIVES. We investigated prospectively the relationships among falls, physical balance, and standing and supine blood pressure (BP) in elderly persons. BACKGROUND. Falls occur often and adversely affect the activities of daily living in the elderly; however, their relationship to BP has not been clarified thoroughly. METHODS. A total of 266 community-dwelling elderly persons age 65 years or over (123 men and 143 women, mean age of 76 years) were selected from among residents of Coop City, Bronx, New York. Balance was evaluated at baseline using computerized dynamic posturography (DPG). During a one-year follow-up, we collected information on subsequent falls on a monthly basis by postcard and telephone follow-up. RESULTS. One or more falls occurred in 60 subjects (22%) during the one-year follow-up. Women fell more frequently than men (28% vs. 16%, p < 0.03), and fallers were younger than nonfallers. Fallers (n = 60) had lower systolic BP (SBP) levels when compared with nonfallers (n = 206) (128 ± 17 vs. 137 ± 22 mm Hg for standing, p < 0.006; 137 ± 16 vs. 144 ± 22 mm Hg for lying, p < 0.02), whereas diastolic BP was not related to falls. Falls occurred 2.8 times more often in the lower BP subgroup (<140 mm Hg for standing SBP) than in the higher BP subgroup (≥140 mm Hg, p < 0.0003), and gender-related differences were observed (p = 0.006): 3.4 times for women (p < 0.0001) versus 1.9 times for men (p = 0.30). Loss of balance, as detected by DPG, did not predict future fills and was also not associated with baseline BP levels. Multiple logistic regression analysis demonstrated that female gender (relative risk [RR] = 2.1, p = 0.02), history of falls (RR = 2.5, p = 0.008) and lower standing SBP level (RR = 0.78 for 10 mm Hg increase, p = 0.005) were independent predictors of falls during one year of follow-up. CONCLUSIONS. Lower standing SBP, even within normotensive ranges, was an independent predictor of falls in the community-dwelling elderly. Elderly women with a history of falls and with lower SBP levels should have more attention paid to the prevention of falls and related accidents.

UR - http://www.scopus.com/inward/record.url?scp=0034972476&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034972476&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(01)01327-4

DO - 10.1016/S0735-1097(01)01327-4

M3 - Article

VL - 38

SP - 246

EP - 252

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 1

ER -