Orthostatic hypotension among outpatients with ischemic stroke

Michael S. Phipps, Arlene A. Schmid, John R. Kapoor, Aldo J. Peixoto, Linda S. Williams, Dawn M. Bravata

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: The treatment of hypertension is an essential component of stroke prevention; however, the clinical management of patients with cerebrovascular disease is complicated by orthostatic hypotension (OH). The primary objectives were to: determine the prevalence of OH in a stroke outpatient clinic; describe categories of OH; and identify factors independently associated with the presence of OH. Methods: Veterans with stroke, cared for in a multidisciplinary stroke clinic, were included. OH was defined as a ≥ 20 mm Hg fall in systolic blood pressure (BP), a ≥ 10 mm Hg fall in diastolic BP, or a ≥ 10 mm Hg fall in systolic BP with symptoms. Multivariable logistic regression was used to identify factors associated with OH including demographics, comorbidites, stroke severity, and baseline BP. Results: Among 60 patients with stroke, 16 (27%) patients had OH. Among those with OH, half were hypertensive, seven were normotensive, and one was hypotensive. A history of coronary artery disease was independently associated with the presence of OH. Conclusions: Orthostatic hypotension is present in about one quarter of outpatients with stroke, and coronary artery disease appears to be a risk factor. Stroke patients should be screened for OH given that the presence of positional BP changes may alter clinical management.

Original languageEnglish (US)
Pages (from-to)62-65
Number of pages4
JournalJournal of the Neurological Sciences
Volume314
Issue number1-2
DOIs
StatePublished - Mar 15 2012

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Keywords

  • Accidental falls
  • Hypotension
  • Orthostatic
  • Risk factors
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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