The duration of the orthostatic blood pressure drop is predictive of XXXX .

@entity1 @entity551 @entity204 @entity1163
BACKGROUND: @entity551 ( @entity551 ) affects 6% of community-dwelling older @entity1 . This increases to 60% when non-invasive, continuous blood pressure (BP) monitoring is used, due to identification of transient drops in BP which recover rapidly. AIM: To determine the clinical relevance of these transient orthostatic BP drops. DESIGN: Five-year clinical observational study. METHODS: One hundred three consecutive new @entity1 attending a Falls and @entity1163 Clinic in the UK from 1 February 2009 underwent continuous BP monitoring during an active stand. BP profiles were analysed to quantify all reductions in BP, measuring the duration of any drop below diagnostic criteria. Five-year follow-up data were extracted from hospital clinical records to assess clinical outcomes. RESULTS: Systolic BP (sBP) dropped >= 20   mmHg in 76 (74%) individuals, with 65 (63%) having >= 10   mmHg drop in diastolic BP. However, only 22 (21%) cases were diagnosed clinically with @entity551 . A sustained reduction in BP (>= 30   s) had a sensitivity of 0.91 and specificity of 0.88 for a clinical diagnosis of @entity551 , being more accurate than absolute BP reduction alone. A sustained reduction in sBP was associated with greater use of vasopressors (36%, P 0.001) and an independent, significantly greater risk of @entity204 (45% at 5 years, P 0.009). CONCLUSION: An orthostatic reduction in sBP lasting >= 30   s improves accuracy of diagnosis. Moreover, given the significant adverse outcomes with a sustained reduction, clinicians should consider this when diagnosing and treating @entity1 , as transient @entity551 does not appear to be clinically significant.
