Abstract P015: Characteristics And Care Of Inpatients With Orthostatic Hypotension

Autor: Benjamin A Wagner, Adam Strauss, Timothy Anderson, Stephen P Juraschek
Rok vydání: 2022
Předmět:
Zdroj: Hypertension. 79
ISSN: 1524-4563
0194-911X
DOI: 10.1161/hyp.79.suppl_1.p015
Popis: Background: Orthostatic hypotension (OH) contributes to over 80,000 hospitalizations annually, yet most studies of OH are conducted in outpatient settings. We sought to better characterize the causes, care, and course of OH in hospitalized patients in a large academic center. Methods: In this observational study, we reviewed 101 electronic medical records of adults with OH during admission to Beth Israel Deaconess Medical Center in Boston between January 1, 2017 and June 30, 2021, extracting details related to symptoms, etiology, interventions, blood pressure (BP), and post-hospital follow-up. OH was defined as a drop in systolic or diastolic BP of at least 20 or 10 mm Hg, respectively. Results: Of these patients (39.6% female, 9.9% Black, mean length of stay of 6.8 days), 30.7% had evidence of OH on initial presentation (Table) . While dizziness (32.7%) and lightheadedness (29.7%) were common, 19.8% of patients were asymptomatic. Volume resuscitation (64.4%), medication changes (53.5%), and physical therapy (24.8%) were the most frequent interventions. Among medication changes, reductions in beta blockers (37.0%) and loop diuretics (27.8%) were most common. On average, orthostatic systolic and diastolic BP improved by 7.9 and 3.0 mm Hg, respectively, and OH improved or resolved in 64.3% of patients. Within six months of discharge, 24.8% of patients had a subsequent encounter for OH. Conclusion: This study identifies important foci for further study of inpatient OH, including detection among asymptomatic patients, clinical practices focused on BP augmentation strategies (volume resuscitation, down-titration of beta blockers and loop diuretics), and high recurrence rates.
Databáze: OpenAIRE
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