Reader Response: Systolic Blood Pressure Postural Changes Variability is Associated With Greater Dementia Risk

I read with interest the study by Rouch et al.,1 investigating whether orthostatic hypotension (OHYPO) and visit-to-visit blood pressure (BP) postural changes were associated with the incidence of dementia in the elderly, and they found systolic OHYPO and BP postural changes were associated with greater dementia risk. In the study, OHYPO was defined as a fall of ≥15 mm Hg in systolic or ≥7 mm Hg in diastolic BP after standing from a sitting position. However, according to the consensus on the detection of OH published in 1996, the diagnosis of OH is made in the event of ≥20 mm Hg decrease in systolic and/or ≥10 mm Hg decrease in diastolic BP after standing.2 Moreover, in many recent published studies using the criteria of this consensus, in the elderly, systolic OHYPO has been associated with frailty, fear of falling, malnutrition, and sarcopenia, all of which are actually known to be predictive for dementia development.3-5

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