TY - JOUR
T1 - The effect of sleeping with the head of the bed elevated six inches on elderly patients with orthostatic hypotension
T2 - An open randomised controlled trial
AU - Fan, Chie Wei
AU - Walsh, Cathal
AU - Cunningham, Conal J.
PY - 2011/3
Y1 - 2011/3
N2 - Background: the evidence for 6-inch tilt sleeping-head-up (SHU), a common therapy for the treatment of orthostatic hypotension (OH) in older people, is unavailable.Objective: to investigate the effects of 6-inch SHU for 6 weeks in community-living patients with chronic OH. Design: open labelled randomised controlled trial. Methods: one hundred patients aged ≥60 with chronic OH were randomised into SHU or control groups. Primary outcome measures were mean arterial pressure (MAP) and symptoms. Repeated measures of orthostatic haemodynamic parameters (systolic blood pressure, diastolic blood pressure, MAP, heart rate, percentage change of Modelflow parameters), weight, frequency of dizziness, 24-h urinary sodium and volume, 24-h ambulatory blood pressure (24-ABPM) and presence of ankle oedema were collected at baseline and at 6 weeks. Results: symptoms improved, to a similar extent, in both groups. There were no differences in MAP or other haemodynamic parameters, weight, urinary volume or 24-ABPM between SHU and controls. SHU were more likely to have leg oedema. Conclusions: these findings suggested that SHU at 6 inches has no additional effects on symptoms or haemodynamic parameters at 6 weeks than existing non-pharmacological measures in older patients with OH. Its use in this group should therefore be discouraged.
AB - Background: the evidence for 6-inch tilt sleeping-head-up (SHU), a common therapy for the treatment of orthostatic hypotension (OH) in older people, is unavailable.Objective: to investigate the effects of 6-inch SHU for 6 weeks in community-living patients with chronic OH. Design: open labelled randomised controlled trial. Methods: one hundred patients aged ≥60 with chronic OH were randomised into SHU or control groups. Primary outcome measures were mean arterial pressure (MAP) and symptoms. Repeated measures of orthostatic haemodynamic parameters (systolic blood pressure, diastolic blood pressure, MAP, heart rate, percentage change of Modelflow parameters), weight, frequency of dizziness, 24-h urinary sodium and volume, 24-h ambulatory blood pressure (24-ABPM) and presence of ankle oedema were collected at baseline and at 6 weeks. Results: symptoms improved, to a similar extent, in both groups. There were no differences in MAP or other haemodynamic parameters, weight, urinary volume or 24-ABPM between SHU and controls. SHU were more likely to have leg oedema. Conclusions: these findings suggested that SHU at 6 inches has no additional effects on symptoms or haemodynamic parameters at 6 weeks than existing non-pharmacological measures in older patients with OH. Its use in this group should therefore be discouraged.
KW - Blood pressure
KW - Elderly
KW - Haemodynamics
KW - Trials
UR - http://www.scopus.com/inward/record.url?scp=79951784504&partnerID=8YFLogxK
U2 - 10.1093/ageing/afq176
DO - 10.1093/ageing/afq176
M3 - Article
C2 - 21233091
AN - SCOPUS:79951784504
SN - 0002-0729
VL - 40
SP - 187
EP - 192
JO - Age and Ageing
JF - Age and Ageing
IS - 2
M1 - afq176
ER -