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PREVALENCIA DE HIPOTENSION ORTOSTATICA EN ADULTOS MAYORES EN MEXICO

(especial para SIIC © Derechos reservados)
La hipotensión ortostática es un problema común, pero en México se desconoce su prevalencia. Hicimos un estudio dónde cerca del 30% de la población de asilos de ancianos mostró el problema. La hipotensión ortostática se vincula con peor calidad de vida y estado cognitivo, así como con distiroidismo, ictus y alcoholismo como factores de riesgo asociados.
Autor:
Enrique Asensio-lafuente
Columnista Experto de SIIC

Institución:
Universidad del Valle de México

Artículos publicados por Enrique Asensio-lafuente
Coautores
Andrea Aguilera* Maria de los Angeles Corral C* Carla Mendoza* Pablo Nava* Ana Lilia Rendón* Liliana Villegas* Juan Manuel Fraga* Enrique Negrete* Lilia Castillo** Arturo Orea** 
Universidad del Valle de México, Querétaro, México*
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, México**
Aprobación
3 de Marzo, 2012 		Primera edición
5 de Octubre, 2012 		Segunda edición, ampliada y corregida
7 de Junio, 2021

PREVALENCIA DE HIPOTENSION ORTOSTATICA EN ADULTOS MAYORES EN MEXICO

Resumen
La hipotensión ortostática (HO) es un problema común en los adultos mayores y se asocia con el aumento de la morbimortalidad, pero su prevalencia se desconoce en México. Métodos: Se realizó un estudio transversal, prospectivo, entre sujetos internados en instituciones de asistencia a los adultos mayores. Se hizo una historia clínica y se tomaron mediciones de presión arterial en posición sedente, inmediatamente después de ponerse de pie y a los 3 minutos de la bipedestación. Resultados: Evaluamos 132 sujetos con una edad promedio de 82.3 ± 9.5 años; el 74.1% fueron mujeres. De ellos, 39 (29.3%) tuvieron HO. Estos pacientes tienen mayor prevalencia de hipotiroidismo, enfermedad de Parkinson, depresión y alcoholismo. El test de Mini Mental dio un puntaje de 15.45 ± 7.2 frente a 16.12 ± 7.9 (p = 0.6) y la escala de calidad de vida mostró un puntaje de 12.1 ± 7.3 frente a 9.15 ± 7.05 (p = 0.03), respectivamente, para los sujetos que tenían HO contra los que no. La presencia de hipertensión y alcoholismo dieron unos valores de riesgo relativo de 2.6 (intervalo de confianza del 95% [IC]: 0.9-7.6, p = 0.06) y 3.18 (IC: 0.96-10.48, p = 0.05), respectivamente, para presentar HO. Conclusiones: Se encontró que el 29.3% de esta población tiene HO. Aunque hay pocos elementos diferenciadores, llaman la atención la hipertensión, el alcoholismo y la historia de ictus. Las diferencias en el uso de medicamentos son mínimas y no explican la HO, por lo que es necesario buscar otras asociaciones, como el alcoholismo. La HO se asocia con peor calidad de vida y peor desempeño cognitivo, aunque muchas veces es asintomática.

Palabras clave
hipotensión ortostática, adultos mayores, disfunción autonómica, alcoholismo, enfermedad de Parkinson


Artículo completo
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Extensión:  +/-7.26 páginas impresas en papel A4
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Orthostatic Hypotension in Mexican Elderly

Abstract
Orthostatic hypotension (OH) is a common problem among the elderly and it is associated with an increase in morbidity and mortality, but its prevalence is unknown in our country.
Methods: We conducted a cross-sectional prospective study in in-patients of several local elderly assistance institutions. We carried out a history and made blood pressure readings in sitting position, immediately after standing up and after a 3-minute stand-up.
Results: We evaluated 132 patients, mean age 82.3 ± 9.5 years, 74.1% female. Thirty-nine subjects (29.3%) have OH. They have a higher prevalence of hypothyroidism, Parkinson's disease, depression and alcoholism. Their Minimental result was 15.45 ± 7.2 vs. 16.12 ± 7.9 (p=0.6) among those without OH, and their quality of life (Minnesota scale) was 12.1 ± 7.3 vs. 9.15 ± 7.05 (p=0.03). OH patients use more ACEI, digoxin and levothyroxin. Hypertension and alcoholism history showed respectively a RR of 2.6 (IC 95% 0.9 - 7.6, p=0.06) and 3.18 (IC 95% 0.96 - 10.48, p=0.05) of developing OH.
Conclusions: OH was present among 29.3% of the studied population. One third of them had hypertension. The use of different medications did not explain OH by itself, so it is necessary to look for different associations. Among those, chronic alcoholism is particularly striking. OH is associated with worse QOL and cognitive performance, although it is asymptomatic in most cases.

Key words
orthostatic hypotension, elderly, alcoholism, Parkinson disease, autonomic dysfunction

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Cardiología, Geriatría
Relacionadas: Atención Primaria, Epidemiología, Medicina Familiar, Medicina Interna



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Enrique Asensio-Lafuente, Universidad del Valle de México, Campus Querétaro, 76230, Blvd. Villas del Mesón 1000, Edificio J, Juriquilla, Querétaro, México
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