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

Andersson, M; Hansson, Oskar LU ; Minthon, Lennart LU ; Ballard, C G and Londos, Elisabet LU (2008) In International Journal of Geriatric Psychiatry 23(2). p.192-198
Abstract
OBJECTIVES: 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). METHODS: 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... (More)
OBJECTIVES: 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). METHODS: 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. RESULTS: OH occurred in 69% of the DLB patients and in 42% of the AD patients, but only in 13% of the controls (p < 0.001 controls vs AD and controls vs DLB, p = 0.001 AD vs DLB) 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. CONCLUSIONS: Patients with DLB react different to orthostatic challenge than patients with AD or controls, with important clinical implications for key disease symptoms and treatment. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
dementia, hypotension, orthostatic, Lewy bodies
in
International Journal of Geriatric Psychiatry
volume
23
issue
2
pages
192 - 198
publisher
John Wiley and Sons Ltd
external identifiers
  • wos:000253472100011
  • pmid:17621385
  • scopus:39749176349
ISSN
1099-1166
DOI
10.1002/gps.1861
language
English
LU publication?
yes
id
e89f955c-2111-4f2f-b12c-abb6e0a956c7 (old id 540901)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17621385&dopt=Abstract
date added to LUP
2008-01-22 13:29:58
date last changed
2017-03-26 03:42:26
@article{e89f955c-2111-4f2f-b12c-abb6e0a956c7,
  abstract     = {OBJECTIVES: 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). METHODS: 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. RESULTS: OH occurred in 69% of the DLB patients and in 42% of the AD patients, but only in 13% of the controls (p &lt; 0.001 controls vs AD and controls vs DLB, p = 0.001 AD vs DLB) 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. CONCLUSIONS: Patients with DLB react different to orthostatic challenge than patients with AD or controls, with important clinical implications for key disease symptoms and treatment.},
  author       = {Andersson, M and Hansson, Oskar and Minthon, Lennart and Ballard, C G and Londos, Elisabet},
  issn         = {1099-1166},
  keyword      = {dementia,hypotension,orthostatic,Lewy bodies},
  language     = {eng},
  number       = {2},
  pages        = {192--198},
  publisher    = {John Wiley and Sons Ltd},
  series       = {International Journal of Geriatric Psychiatry},
  title        = {The period of hypotension following orthostatic challenge is prolonged in dementia with Lewy bodies.},
  url          = {http://dx.doi.org/10.1002/gps.1861},
  volume       = {23},
  year         = {2008},
}