Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?

Ali Ekrem Aydin,1 Pinar Soysal,2 Ahmet Turan Isik1 1Center for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; 2Kayseri Education and Research Hospital, Geriatric Center, Kayseri, Turkey Background: Correct evaluation of ortho...

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Autores principales:	Aydin AE, Soysal P, Isik AT
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Active Standing Test Head-Up Tilt Table Orthostatic Hypotension diagnosis Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/f0713232b3654077aa77dc363a3d4a0a
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spelling	oai:doaj.org-article:f0713232b3654077aa77dc363a3d4a0a2021-12-02T08:46:56ZWhich is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?1178-1998https://doaj.org/article/f0713232b3654077aa77dc363a3d4a0a2017-01-01T00:00:00Zhttps://www.dovepress.com/which-is-preferable-for-orthostatic-hypotension-diagnosis-in-older-adu-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Ali Ekrem Aydin,1 Pinar Soysal,2 Ahmet Turan Isik1 1Center for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; 2Kayseri Education and Research Hospital, Geriatric Center, Kayseri, Turkey Background: Correct evaluation of orthostatic hypotension (OH) is crucial in geriatric practice, since OH is associated with mortality and morbidity. The study aimed to determine the most appropriate method for measuring blood pressure in transition from supine to upright position in order to diagnose OH in older adults.Methods: Active standing test (AST) and head-up tilt table (HUT) test as well as comprehensive geriatric assessment (CGA), including mini-mental state examination or the cognitive state test, mini-nutritional assessment, basic and instrumental activities of daily living, and Tinetti performance-oriented mobility assessment indexes, were performed in 290 geriatric patients.Results: The prevalence of OH during HUT and AST was 19% and 37%, respectively. In patients with OH during HUT, the frequency of dementia and recurrent falls were higher (P<0.05); on the other hand, the levels of serum vitamin D and albumin and estimated glomerular filtration rate were lower (P<0.05). However, all these parameters for OH during AST were not significant (P>0.05). Comparison of the groups according to CGA measurements revealed significant differences in terms of cognition, nutritional status, activities of daily life, and balance function in patients with OH only during HUT (P<0.05), but not during AST (P>0.05). The sensitivity, specificity, positive predictive value, and negative predictive values of AST were 49.0%, 65.5%, 25.0%, and 84.6% respectively, according to HUT.Conclusion: The results suggest that orthostatic blood pressure changes determined by HUT might be of higher clinical significance than that by AST in older adults. It might be important that the evaluation of OH by HUT should be included in daily geriatric practice. Keywords: active standing test, head-up tilt table, orthostatic hypotension, diagnosisAydin AESoysal PIsik ATDove Medical PressarticleActive Standing TestHead-Up Tilt TableOrthostatic HypotensiondiagnosisGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 207-212 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Active Standing Test Head-Up Tilt Table Orthostatic Hypotension diagnosis Geriatrics RC952-954.6
spellingShingle	Active Standing Test Head-Up Tilt Table Orthostatic Hypotension diagnosis Geriatrics RC952-954.6 Aydin AE Soysal P Isik AT Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?
description	Ali Ekrem Aydin,1 Pinar Soysal,2 Ahmet Turan Isik1 1Center for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; 2Kayseri Education and Research Hospital, Geriatric Center, Kayseri, Turkey Background: Correct evaluation of orthostatic hypotension (OH) is crucial in geriatric practice, since OH is associated with mortality and morbidity. The study aimed to determine the most appropriate method for measuring blood pressure in transition from supine to upright position in order to diagnose OH in older adults.Methods: Active standing test (AST) and head-up tilt table (HUT) test as well as comprehensive geriatric assessment (CGA), including mini-mental state examination or the cognitive state test, mini-nutritional assessment, basic and instrumental activities of daily living, and Tinetti performance-oriented mobility assessment indexes, were performed in 290 geriatric patients.Results: The prevalence of OH during HUT and AST was 19% and 37%, respectively. In patients with OH during HUT, the frequency of dementia and recurrent falls were higher (P<0.05); on the other hand, the levels of serum vitamin D and albumin and estimated glomerular filtration rate were lower (P<0.05). However, all these parameters for OH during AST were not significant (P>0.05). Comparison of the groups according to CGA measurements revealed significant differences in terms of cognition, nutritional status, activities of daily life, and balance function in patients with OH only during HUT (P<0.05), but not during AST (P>0.05). The sensitivity, specificity, positive predictive value, and negative predictive values of AST were 49.0%, 65.5%, 25.0%, and 84.6% respectively, according to HUT.Conclusion: The results suggest that orthostatic blood pressure changes determined by HUT might be of higher clinical significance than that by AST in older adults. It might be important that the evaluation of OH by HUT should be included in daily geriatric practice. Keywords: active standing test, head-up tilt table, orthostatic hypotension, diagnosis
format	article
author	Aydin AE Soysal P Isik AT
author_facet	Aydin AE Soysal P Isik AT
author_sort	Aydin AE
title	Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?
title_short	Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?
title_full	Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?
title_fullStr	Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?
title_full_unstemmed	Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?
title_sort	which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/f0713232b3654077aa77dc363a3d4a0a
work_keys_str_mv	AT aydinae whichispreferablefororthostatichypotensiondiagnosisinolderadultsactivestandingtestorheaduptilttabletest AT soysalp whichispreferablefororthostatichypotensiondiagnosisinolderadultsactivestandingtestorheaduptilttabletest AT isikat whichispreferablefororthostatichypotensiondiagnosisinolderadultsactivestandingtestorheaduptilttabletest
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Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?

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