1 Non-Communicable Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
2 Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
3 Medical Statistics Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

Address correspondence to: S. Kamaruzzaman. Email: shahrul.kamaruzzaman@lshtm.ac.uk

Objective: to determine the prevalence of orthostatic hypotension (OH) and associations with medication use in community-dwelling older women.

Design: cross-sectional analysis using data from the British Women’s Heart and Health Study.

Setting: general practices in 23 towns in the UK.

Participants: 3,775 women aged 60–80 years from 1999 to 2001.

Main outcome measure: orthostatic hypotension—drop of 20 mmHg in systolic and/or a drop of 10 mmHg in diastolic blood pressure on standing.

Results: prevalence of OH was 28% (95% confidence interval [CI] 26.6, 29.4), which increased with age and hypertension. Regardless of treatment status or diagnosed hypertension, raised blood pressure was strongly associated with OH (P < 0.001). OH was strongly associated with number of antihypertensives taken (none vs three or more: odds ratio [OR] 2.24, 95% CI 1.47–3.40, P < 0.001); the association was slightly attenuated after allowing for age and co-morbidities (OR 1.99; 95% CI 1.30, 3.05; P = 0.003). Women with multiple co-morbidities had markedly increased odds of OH independent of age, number and type of medications taken (none vs four or more diagnoses: OR 2.28, 95% CI 1.58–3.30, P = 0.005).

Conclusion: uncontrolled hypertension, use of three or more antihypertensives and multiple co-morbidities are predictors of OH in older women. Detection or monitoring of OH in these groups may prevent women from suffering its adverse consequences.

Keywords: orthostatic hypotension, prevalence, medication, elderly