Ambulatory Blood Pressure Monitoring Contributes to Hypotension Diagnosis in NH Residents

Research shows a significant predisposition for hypotensive episodes in nursing home (NH) residents, but ambulatory blood pressure monitoring (ABPM) can aid in the diagnosis of hypotension in these older adults.

According to authors of a study published in the Journal of the American Geriatrics Society, of the 91 NH residents included in the sample, 55% experienced hypotensive episodes with 38% reaching a minimum systolic BP (SBP) of <90 mmHg.

“Residents with hypotensive episodes showed a higher prevalence of heart failure and atrial fibrillation and more commonly received digoxin and benzodiazepines, while antihypertensive prescriptions were similar between the two groups,” stated study authors.

Researchers noted that in terms of functional status, cognitive performance, and comorbidity burden, there was no significant difference.

“At multivariable analysis, hypotensive episodes were independently associated with digoxin (OR 20.0, 95% CI 2.21–181.19, P = .008), benzodiazepines (OR 4.0, 95% CI 1.45–11.22, P = .007), and serum creatinine <1 mg/dl (OR 3.9, 95% CI 1.28–12.17, P = .017),” stated study authors.

Furthermore, study authors discussed that older adults with cognitive impairment are less likely to report symptoms of hypotension, which means hypotensive episodes that would normally go undetected can be revealed through ABPM.

“Finally, our study revealed an independent association between hypotensive episodes and low serum creatinine, which is common in older adults with sarcopenia,” stated authors of the study. “This implies a link between low muscle mass and hypotensive risk, possibly deriving from the crucial role of muscle mass in the BP response to gravity stress.”

Reference:
Rivasi G, Mossello E, Turrin G, et al. Hypotensive episodes revealed by ambulatory blood pressure monitoring in nursing home residents. J Am Geriatr Soc. 2021;1-4. doi:10.1111/jgs.17570