People who get dizzy several minutes after standing up may be at risk of more serious conditions and even an increased risk of death, according to new research published in the September 23, 2015, online issue of Neurology, the medical journal of the American Academy of Neurology. Feeling dizzy, faint or light-headed after standing due to a sudden drop in blood pressure can be a minor problem due to medication use or dehydration. But when it happens often, it can be a sign of a more serious condition called orthostatic hypotension, which is defined as a drop in blood pressure within three minutes of sitting or standing.
“Our study looked at delayed orthostatic hypotension, when the drop in blood pressure happens more than three minutes after standing or sitting up,” said study author Christopher Gibbons, MD, with Harvard Medical School in Boston and a Fellow with the American Academy of Neurology. “Our findings suggest that more than half of people with the delayed form of this condition will go on to develop the more serious form of this disease. This is also the first study to date suggesting the disease is a milder form of the more common and serious disorder.”
For the study, researchers reviewed the medical records of 165 people with an average age of 59 who completed nervous system testing and were followed for 10 years. Of those, 48 were diagnosed with delayed orthostatic hypotension, 42 had orthostatic hypotension and 75 did not have either condition.
The study found that over 10 years, 54 percent of participants with delayed orthostatic hypotension progressed to orthostatic hypotension and 31 percent developed a degenerative brain disease such as Parkinson’s or dementia with Lewy bodies.
The rate of death over 10 years was 29 percent for people with delayed orthostatic hypotension, 64 percent for those with orthostatic hypotension (the more serious form of the disease) and 9 percent in people without either condition. The death rate over 10 years for those with the delayed condition who progressed to orthostatic hypotension was 50 percent.
People with delayed orthostatic hypotension who also had diabetes at the beginning of the study were more likely to develop the full condition than those without diabetes.
Many of the people with the delayed condition that did not develop the full condition were taking medications that may have affected their blood pressure, such as diuretics, antidepressants and high blood pressure drugs.
“Our findings may lead to earlier recognition, diagnosis and treatments of this condition and possibly other underlying diseases that may contribute to early death,” said Gibbons.
Gibbons said limitations of the study included that it was a retrospective review of data collected earlier and that participants were all referred to a specialized center for tests of the autonomic nervous system and may not reflect the overall community.
About this neurology research
Source: Rachel Seroka – AAN Image Credit: The image is in the public domain Original Research:Abstract for “Clinical implications of delayed orthostatic hypotension: A 10-year follow-up study” by Christopher H. Gibbons and Roy Freeman in Neurology. Published online September 23 2015 doi:10.1212/WNL.0000000000002030
Clinical implications of delayed orthostatic hypotension: A 10-year follow-up study
Objective: To define the long-term outcome of delayed orthostatic hypotension (OH).
Hypothesis: Delayed OH is an early and milder form of OH that progresses over time.
Methods: We reviewed the medical records of 230 previously reported patients who completed autonomic testing at our center from January 1, 2002, through December 31, 2003. All available information on clinical diagnosis, mortality, medication use, and autonomic testing were extracted and included in the reported outcomes. Standard criteria were used to define OH and delayed OH.
Results: Forty-eight individuals with delayed OH, 42 individuals with OH, and 75 controls had complete follow-up data. Fifty-four percent of individuals with delayed OH progressed to OH. Thirty-one percent of individuals with delayed OH developed an α-synucleinopathy. The 10-year mortality rate in individuals with delayed OH was 29%, in individuals with baseline OH was 64%, and in controls was 9%. The 10-year mortality of individuals who progressed to OH was 50%. Progression to OH was associated with developing an α-synucleinopathy, baseline diabetes, and abnormal baseline autonomic test results.
Conclusion: Delayed OH frequently progresses to OH with a high associated mortality.
“Clinical implications of delayed orthostatic hypotension: A 10-year follow-up study” by Christopher H. Gibbons and Roy Freeman in Neurology. Published online September 23 2015 doi:10.1212/WNL.0000000000002030