Orthostatic blood pressure fluctuations and risk of falls in community-dwelling older adults: the role of recovery time.
6 affiliations
- 1Institute of Geriatric Research, Ulm University Medical Center, Ulm, Germany.
- 2Institute of Epidemiology and Medical Biometry, University Ulm, Ulm, Germany.
- 3Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Ulm, Germany.
- 4Institute of Geriatric Research, Ulm University Medical Center, Ulm, Germany. [email protected].
- 5Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Ulm, Germany. [email protected].
- 6Dept. of Epidemiology, Boston University School of Public Health, Boston, MA, USA. [email protected].
Abstract
Background
Available literature related to the association between orthostatic blood pressure (BP) variations and falls is controversial. We analyzed how orthostatic hypo- (OH) and hypertension (OHTN) relate to falls considering recovery time (RT) in community-dwelling older adults.Methods
This analysis uses data from the ActiFE cohort. BP was measured lying, immediately, 1, 2 and 3 min after standing. Systolic OH (sOH) and systolic OHTN (sOHTN) indicate a systolic BP (SBP) drop or increment ≥20 mm Hg, respectively. OH and OHTN further consider a diastolic BP (DBP) drop or increment ≥10 mm Hg. RT was categorized as Early Recovery ( < 1 min), Delayed Recovery (1-3 min), or No Recovery. Falls over 12 months were collected prospectively. Logistic regression examined associations with falls, adjusting for age, sex, diabetes, hemoglobin, instrumental activities of daily living, hand strength, fall risk-increasing drugs, past falls, Falls Efficacy Scale-International and anxiety.Results
Among 509 subjects (mean age 79 years, 44% female, 168 falls), prevalences were: 16.5% sOH, 26.9% OH, 9.0% sOHTN and 15.5% OHTN. Overall, OH was not associated with falls. However, falls risk increased with Delayed (OR 3.11 [95% CI 1.21-8.01]) and NoRecovery (OR 4.04 [95% CI 1.07-15.26]). sOH showed an adjusted OR of 2.00 [95% CI 1.15-3.47] for at least one fall. Regarding RT the risk of falls was increased in Delayed (OR 4.73 [95% CI 1.71-13.10]) and No Recovery (OR 5.06 [95% CI 1.42-22.27]). OHTN was not associated with falls.Conclusions
Overall, only sOH was associated with falls. When RT was considered, those with Delayed and No Recovery showed higher risk of falls regardless of the OH definition used.
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BibTeX
@article{alvarez2026orthostatic,
title = {{Orthostatic blood pressure fluctuations and risk of falls in community-dwelling older adults: the role of recovery time.}},
author = {Valeria Arbieto Alvarez and Clara Hertneck and Dietrich Rothenbacher and Michael Denkinger and Dhayana Dallmeier},
journal = {BMC geriatrics},
year = {2026},
month = oct,
doi = {10.1186/s12877-026-08516-1},
url = {https://europepmc.org/article/MED/42958062},
note = {CC BY},
}
RIS
TY - JOUR
TI - Orthostatic blood pressure fluctuations and risk of falls in community-dwelling older adults: the role of recovery time.
AU - Valeria Arbieto Alvarez
AU - Clara Hertneck
AU - Dietrich Rothenbacher
AU - Michael Denkinger
AU - Dhayana Dallmeier
PY - 2026
DA - 2026/10/28
JO - BMC geriatrics
DO - 10.1186/s12877-026-08516-1
UR - https://europepmc.org/article/MED/42958062
AB - Background Available literature related to the association between orthostatic blood pressure (BP) variations and falls is controversial. We analyzed how orthostatic hypo- (OH) and hypertension (OHTN) relate to falls considering recovery time (RT) in community-dwelling older adults.Methods This analysis uses data from the ActiFE cohort. BP was measured lying, immediately, 1, 2 and 3 min after standing. Systolic OH (sOH) and systolic OHTN (sOHTN) indicate a systolic BP (SBP) drop or increment ≥20 mm Hg, respectively. OH and OHTN further consider a diastolic BP (DBP) drop or increment ≥10 mm Hg. RT was categorized as Early Recovery ( < 1 min), Delayed Recovery (1-3 min), or No Recovery. Falls over 12 months were collected prospectively. Logistic regression examined associations with falls, adjusting for age, sex, diabetes, hemoglobin, instrumental activities of daily living, hand strength, fall risk-increasing drugs, past falls, Falls Efficacy Scale-International and anxiety.Results Among 509 subjects (mean age 79 years, 44% female, 168 falls), prevalences were: 16.5% sOH, 26.9% OH, 9.0% sOHTN and 15.5% OHTN. Overall, OH was not associated with falls. However, falls risk increased with Delayed (OR 3.11 [95% CI 1.21-8.01]) and NoRecovery (OR 4.04 [95% CI 1.07-15.26]). sOH showed an adjusted OR of 2.00 [95% CI 1.15-3.47] for at least one fall. Regarding RT the risk of falls was increased in Delayed (OR 4.73 [95% CI 1.71-13.10]) and No Recovery (OR 5.06 [95% CI 1.42-22.27]). OHTN was not associated with falls.Conclusions Overall, only sOH was associated with falls. When RT was considered, those with Delayed and No Recovery showed higher risk of falls regardless of the OH definition used.
SN - 1471-2318
ER -