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Vitamin D deficiency is associated with orthostatic hypotension in oldest‐old women
Author(s) -
Annweiler C.,
Schott A.M.,
Rolland Y.,
Beauchet O.
Publication year - 2014
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12201
Subject(s) - medicine , orthostatic vital signs , vitamin d deficiency , vitamin , vitamin d and neurology , physiology , endocrinology , blood pressure
Objectives Orthostatic hypotension, a condition that mostly affects ‘oldest‐old’ (i.e. ≥80 years) adults, is primarily explained by age‐related dysfunction of blood pressure control. Vitamin D may contribute to blood pressure control. The aim of this study was to determine whether vitamin D deficiency is associated with orthostatic hypotension in oldest‐old adults. Design Cross‐sectional analysis at baseline of the EPIDOS study. Setting Five F rench areas. Participants A total of 329 community‐dwelling oldest‐old women (mean age 83.3 ± 0.2 years). Main outcomes measures Orthostatic hypotension was defined as a systolic blood pressure drop of ≥20 mmHg and/or a diastolic blood pressure drop of ≥10 mmHg within 3 min of standing. Vitamin D deficiency was defined as a serum 25‐hydroxyvitamin D (25O HD ) concentration ≤10 ng mL −1 . Covariates included in the models were age, body mass index, diabetes mellitus, supine mean arterial pressure, number of drugs taken per day, use of antihypertensive or psychoactive drugs, cognition, quadriceps strength, current smoking, alcohol consumption, serum concentrations of parathyroid hormone, calcium and creatinine and season of testing. Results Diastolic orthostatic hypotension was observed more often among women with vitamin D deficiency (19.2%) compared to those without (10.0%; P = 0.03). There was an inverse linear association between 25 OHD concentration and change in diastolic blood pressure after 3 min of standing (adjusted β = −0.07, P = 0.046). Similarly, 25 OHD deficiency was associated with orthostatic hypotension [adjusted odds ratio ( OR ) 3.36, P = 0.004], specifically with diastolic orthostatic hypotension (adjusted OR 3.81, P = 0.003). Conclusions 25 OHD deficiency was associated with orthostatic hypotension in oldest‐old women, due to a greater drop in diastolic blood pressure on standing. This finding may lead to better understanding of the pathophysiology of falls in oldest‐old adults with vitamin D deficiency.