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Lower standing systolic blood pressure as a predictor of falls in the elderly: a community-based prospective study

Kazuomi Kario, MD, PhD, FACC, FACP^{* b}, Jonathan N. Tobin, PhD^* , Leslie I. Wolfson, MD ^||, Robert Whipple, MA, RPT ^||, Carol A. Derby, PhD, Devender Singh, MD, Paul R. Marantz, MD, MPH and Sylvia Wassertheil-Smoller, PhD

^* Clinical Directors Network, Inc., New York, New York, USA
^b The Zena and Michael A. Wiener Cardiovascular Center, Mount Sinai School of Medicine, Bronx, New York, USA
Department of Epidemiology and Social Medicine, Bronx, New York, USA
Department of Neurology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, USA
^|| Department of Neurology, University of Connecticut Health Center, Farmington, Connecticut, USA

View larger version (29K): [in a new window]   Figure 1 Blood pressure levels at rest and during active standing test in fallers and nonfallers p < 0.001 for systolic BP (three measures: supine, just after standing, 2 min after standing), p = 0.01 for falls status (fallers vs. nonfallers), p = 0.69 for interaction between systolic BP and falls status. Open circle = nonfallers; solid circle = fallers.

View larger version (34K): [in a new window]   Figure 2 Incidence of falls in subgroups classified according to standing systolic blood pressure (BP) level. Global 2-values are 18.2 (p = 0.001) for total group, 13.5 (p = 0.009) for women and 5.6 (p = 0.23) for men. Multiple logistic regression analysis including female gender (female = 1, male = 0), standing BP subgroup and their interaction showed that falls were significantly associated with female gender (RR = 4.0, p < 0.05).