LAUSR

Objective: The aim of this study was to examine the prevalence of postural hypotension and the risk factors among hypertensive patients in a primary care setting. Design and method: This is a cross-sectional questionnaire study carried out at the University Malaya of Medical Centre Primary Care Clinic from July 2017 to July 2019. Patients aged = /> 18 years with hypertension were consecutively recruited.. Hypertension was defined as systolic blood pressure (BP) = /> 140mmHg or diastolic BP = /> 90mmHg or taking antihypertensive medication. Postural hypotension in this study was defined as a fall in systolic BP (SBP) of = /> 20mmHg or diastolic BP (DBP) of = /> 10mmHg when getting up from sitting to standing position. Associations between the risk factors/ determinants (sociodemographic & medical comorbidities) with postural hypotension were assessed using Chi-Square test and odds ratio. Confounders were assessed using bivariate logistic regression. Results: 682 hypertensive patients were included in this study: Mean age 66.1 +/- 9.9 years, 56.9% female, mean BMI 27.06 +/- 5.14 kg/m2. Mean SBP was 144.5 +/- 19.1 mmHg and DBP was 82.5 +/- 10.8 mmHg, and mean heart rate was 71 +/- 12 beat/min. Prevalence of postural hypotension was 3.5% (n = 24), 1.5% had a decrease of = /> 20mmHg in SBP and 2.1% had a decrease of = /> 10 mmHg in DBP. Table 1 shows the determinants of postural hypotension among the respondents. Hypertensive patients with heart failure had a significantly higher prevalence of postural hypotension (18.2%) than those without heart failure (3.3%) (X(1) = 7.080, p = 0.008). Table 2 shows the odds ratio between determinant and postural hypotension among the respondents. The odds of having postural hypotension was higher in hypertensive patients with heart failure (OR: 6.556, 95% CI: 1.337 – 32.147, p = 0.02). Bivariate logistic regression did not attenuate this finding. For other variables studied, there was no statistically significant association with postural hypotension. Conclusions: The prevalence of postural hypotension was low at 3.5% among hypertensive patients. Hypertensive patients with comorbid heart failure were 6.6 times more likely to have postural hypotension.