{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T01:33:39Z","timestamp":1790472819313,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001602","name":"Science Foundation Ireland","doi-asserted-by":"publisher","award":["18\/FRL\/6188"],"award-info":[{"award-number":["18\/FRL\/6188"]}],"id":[{"id":"10.13039\/501100001602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Orthostatic hypotension (OH) can be assessed with non-invasive continuous beat-to-beat haemodynamic monitoring during active stand (AS) testing; this yields large volumes of data outside the scope of the traditional OH definition. We explored clinical associations of different AS patterns in participants from Wave 1 of the Irish Longitudinal Study on Ageing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>AS patterns were generated based on three sequential binary systolic blood pressure features: drop \u226540\u00a0mmHg within 10\u00a0sec post-stand (\u201cimmediate deficit\u201d), failure to return to within 20\u00a0mmHg of supine level at 40\u00a0sec after standing (\u201cstabilisation deficit\u201d) and drop \u226520\u00a0mmHg between &amp;gt;40 and 120\u00a0sec post-stand (\u201clate deficit\u201d). Eight AS groups resulted from combining the presence\/absence of these three features. The groups were cross-sectionally characterised, and their ability to independently predict orthostatic intolerance (OI) during AS, and falls or syncope in the past year, was evaluated using multivariate logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4,899 participants were included (mean age 61), of which 3,312 (68%) had no deficits. Older age was associated with stabilisation deficit and late deficits were seen in groups with higher proportions of beta blockers and psychotropic medications. Regression models identified independent associations between OI and three immediate-deficit groups; associations seemed stronger as more deficits were present. There was a significant association between falls history and the three-deficit group (odds ratio 1.54, 95% confidence interval: 1.15\u20132.07, P\u00a0=\u20090.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>More deficits seemed associated with the higher risk of OI and falls history. Observations are not causal but the recognition of these patterns may help clinicians focus on careful prescribing.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ageing\/afaa174","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T19:12:25Z","timestamp":1595617945000},"page":"854-860","source":"Crossref","is-referenced-by-count":24,"title":["Clinical clustering of eight orthostatic haemodynamic patterns in The Irish Longitudinal Study on Ageing (TILDA)"],"prefix":"10.1093","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6969-0175","authenticated-orcid":false,"given":"David","family":"Moloney","sequence":"first","affiliation":[{"name":"The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland"},{"name":"Falls and Syncope Unit, Mercer\u2019s Institute for Successful Ageing, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7090-9293","authenticated-orcid":false,"given":"John","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Newman","sequence":"additional","affiliation":[{"name":"The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Scarlett","sequence":"additional","affiliation":[{"name":"The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Hernandez","sequence":"additional","affiliation":[{"name":"The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose Anne","family":"Kenny","sequence":"additional","affiliation":[{"name":"The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland"},{"name":"Falls and Syncope Unit, Mercer\u2019s Institute for Successful Ageing, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Romero-Ortuno","sequence":"additional","affiliation":[{"name":"The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland"},{"name":"Falls and Syncope Unit, Mercer\u2019s Institute for Successful Ageing, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,4]]},"reference":[{"key":"2021050516071908000_ref1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1093\/gerona\/gly188","article-title":"The prevalence of orthostatic hypotension: a systematic review and meta-analysis","volume":"75","author":"Saedon","year":"2020","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2021050516071908000_ref2","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.jamda.2018.11.003","article-title":"Orthostatic hypotension and falls in older adults: a systematic review and meta-analysis","volume":"20","author":"Mol","year":"2019","journal-title":"J Am Med Dir Assoc"},{"key":"2021050516071908000_ref3","doi-asserted-by":"crossref","first-page":"317","DOI":"10.3233\/JAD-190402","article-title":"Orthostatic hypotension: an important risk factor for clinical progression to mild cognitive impairment or dementia. The Amsterdam dementia cohort","volume":"71","author":"Kleipool","year":"2019","journal-title":"J Alzheimers Dis"},{"key":"2021050516071908000_ref4","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1136\/heartjnl-2013-304121","article-title":"Orthostatic hypotension and mortality risk: a meta-analysis of cohort studies","volume":"100","author":"Xin","year":"2014","journal-title":"Heart"},{"key":"2021050516071908000_ref5","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s10286-011-0119-5","article-title":"Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome","volume":"21","author":"Freeman","year":"2011","journal-title":"Clin Auton Res"},{"key":"2021050516071908000_ref6","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/MBP.0b013e3280b083bd","article-title":"Measuring orthostatic hypotension with the Finometer device: is a blood pressure drop of one heartbeat clinically relevant?","volume":"12","author":"van der Velde","year":"2007","journal-title":"Blood Press Monit"},{"key":"2021050516071908000_ref7","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/bmb\/ldv025","article-title":"Diagnosing orthostatic hypotension: a narrative review of the evidence","volume":"115","author":"Frith","year":"2015","journal-title":"Br Med Bull"},{"key":"2021050516071908000_ref8","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1042\/CS20060091","article-title":"Initial orthostatic hypotension: review of a forgotten condition","volume":"112","author":"Wieling","year":"2007","journal-title":"Clin Sci (Lond)"},{"key":"2021050516071908000_ref9","first-page":"365","article-title":"Detecting initial orthostatic hypotension: a novel approach","volume":"9","author":"McJunkin","year":"2015","journal-title":"JASH"},{"key":"2021050516071908000_ref10","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s10286-009-0040-3","article-title":"Intolerance to initial orthostasis relates to systolic BP changes in elders","volume":"20","author":"Romero-Ortuno","year":"2010","journal-title":"Clin Auton Res"},{"key":"2021050516071908000_ref11","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1111\/jgs.14563","article-title":"Impaired orthostatic blood pressure recovery is associated with unexplained and injurious falls","volume":"65","author":"Finucane","year":"2017","journal-title":"J Am Geriatr Soc"},{"key":"2021050516071908000_ref12","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s10286-019-00606-y","article-title":"A practical guide to active stand testing and analysis using continuous beat-to-beat non-invasive blood pressure monitoring","volume":"29","author":"Finucane","year":"2019","journal-title":"Clin Auton Res"},{"key":"2021050516071908000_ref13","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/1471-2318-13-73","article-title":"Insights into the clinical management of the syndrome of supine hypertension--orthostatic hypotension (SH-OH): the Irish longitudinal study on ageing (TILDA)","volume":"13","author":"Romero-Ortuno","year":"2013","journal-title":"BMC Geriatr"},{"key":"2021050516071908000_ref14","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/j.jamda.2018.05.031","article-title":"Hemodynamic mechanisms underlying initial orthostatic hypotension, delayed recovery and orthostatic hypotension","volume":"19","author":"van Wijnen","year":"2018","journal-title":"J Am Med Dir Assoc"},{"key":"2021050516071908000_ref15","doi-asserted-by":"crossref","first-page":"e014686","DOI":"10.1161\/JAHA.119.014686","article-title":"Accumulation of deficits as a key risk factor for cardiovascular morbidity and mortality: a pooled analysis of 154 000 individuals","volume":"9","author":"Farooqi Mohammed","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2021050516071908000_ref16","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1093\/ije\/dyr116","article-title":"Cohort profile: the Irish longitudinal study on ageing","volume":"40","author":"Kearney","year":"2011","journal-title":"Int J Epidemiol"},{"key":"2021050516071908000_ref17","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1093\/ije\/dyy163","article-title":"Cohort profile update: the Irish longitudinal study on ageing (TILDA)","volume":"47","author":"Donoghue","year":"2018","journal-title":"Int J Epidemiol"},{"key":"2021050516071908000_ref18","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1161\/HYPERTENSIONAHA.119.14040","article-title":"Impact of standing speed on the peripheral and central hemodynamic response to orthostasis","volume":"75","author":"O\u2019Connor John","year":"2020","journal-title":"Hypertension"},{"key":"2021050516071908000_ref19","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s10286-017-0409-7","article-title":"Do we need to evaluate diastolic blood pressure in patients with suspected orthostatic hypotension?","volume":"27","author":"Fedorowski","year":"2017","journal-title":"Clin Auton Res"},{"key":"2021050516071908000_ref20","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1161\/HYPERTENSIONAHA.117.10542","article-title":"Longitudinal association between orthostatic hypotension at 30 seconds post-standing and late-life depression","volume":"71","author":"Briggs","year":"2018","journal-title":"Hypertension"},{"key":"2021050516071908000_ref21","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1161\/CIRCULATIONAHA.114.009831","article-title":"Age-related normative changes in phasic orthostatic blood pressure in a large population study: findings from the Irish longitudinal study on ageing (TILDA)","volume":"130","author":"Finucane","year":"2014","journal-title":"Circulation"},{"key":"2021050516071908000_ref22","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2021050516071908000_ref23","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/joim.12021","article-title":"Syndromes of orthostatic intolerance: a hidden danger (review)","volume":"273","author":"Fedorowski","year":"2013","journal-title":"J Intern Med"},{"key":"2021050516071908000_ref24","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.ejim.2019.10.032","article-title":"Effects of benzodiazepines on orthostatic blood pressure in older people","volume":"72","author":"Rivasi","year":"2020","journal-title":"Eur J Intern Med"},{"key":"2021050516071908000_ref25","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1100\/tsw.2001.58","article-title":"Accumulation of deficits as a proxy measure of aging","volume":"1","author":"Mitnitski","year":"2001","journal-title":"ScientificWorldJournal"},{"key":"2021050516071908000_ref26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2318-2-1","article-title":"Frailty, fitness and late-life mortality in relation to chronological and biological age","volume":"2","author":"Mitnitski","year":"2002","journal-title":"BMC Geriatr"},{"issue":"107","key":"2021050516071908000_ref27","first-page":"506","article-title":"Initial orthostatic hypotension is unrelated to orthostatic tolerance in healthy young subjects","volume":"2009","author":"Thomas","year":"1985","journal-title":"J Appl Physiol"},{"key":"2021050516071908000_ref28","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.ijcard.2018.05.043","article-title":"Initial orthostatic hypotension among patients with unexplained syncope: an overlooked diagnosis?","volume":"271","author":"van Twist","year":"2018","journal-title":"Int J Cardiol"},{"key":"2021050516071908000_ref29","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/ageing\/aft112","article-title":"The prevalence and pathological correlates of orthostatic hypotension and its subtypes when measured using beat-to-beat technology in a sample of older adults living in the community","volume":"42","author":"Cooke","year":"2013","journal-title":"Age Ageing"},{"key":"2021050516071908000_ref30","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.2337\/diacare.24.10.1783","article-title":"Orthostatic hypertension in patients with type 2 diabetes","volume":"24","author":"Yoshinari","year":"2001","journal-title":"Diabetes Care"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/50\/3\/854\/37808164\/afaa174.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/50\/3\/854\/37808164\/afaa174.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T11:08:09Z","timestamp":1667560089000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/50\/3\/854\/5901355"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,4]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,9,4]]},"published-print":{"date-parts":[[2021,5,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afaa174","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,5]]},"published":{"date-parts":[[2020,9,4]]}}}