The period of hypotension following orthostatic challenge is prolonged in dementia with Lewy bodies

Authors:
ANDERSSON S., et al
Journal article citation:
International Journal of Geriatric Psychiatry, 23(2), February 2008, pp.192-198.
Publisher:
Wiley

The aim was to determine whether orthostatic hypotension (OH) is more common in patients with dementia than in older people without cognitive impairment and to identify key differences in the profile of the orthostatic response and the pulse drive during orthostatic challenge between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB).The orthostatic response was evaluated in 235 patients with AD, 52 patients with DLB and 62 elderly controls. The blood pressure and pulse rate were measured in supine position, immediately after standing up and after 1, 3, 5 and 10 min of standing. OH was defined as a reduction of systolic blood pressure (SBP) of at least 20 mm Hg or a reduction of diastolic blood pressure (DBP) of at least 10 mm Hg. OH occurred in 69% of the DLB patients and in 42% of the AD patients, but only in 13% of the controls. The DLB patients had a greater drop in SBP than the other study groups during orthostatic challenge and had a more prolonged period of orthostasis. The pulse drive on orthostatic challenge was similar in between groups. However, in the DLB group it was not adequate to restore the blood pressure to supine values. Patients with DLB react different to orthostatic challenge than patients with AD or controls, with important clinical implications for key disease symptoms and treatment.

Subject terms:
older people, patients, dementia, heart diseases;
Content type:
research
Link:
Journal home page
ISSN online:
1099-1166
ISSN print:
0885-6230

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