La reducción de la presión arterial ortostática se asocia con daño renal en pacientes ancianos autónomos con hipertensión arterial.

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Bibliographic Details
Title:	La reducción de la presión arterial ortostática se asocia con daño renal en pacientes ancianos autónomos con hipertensión arterial.
Alternate Title:	Orthostatic blood pressure reduction is associated with renal damage in functionally preserved elderly hypertensive patients.
Authors:	Ramos-Galí, Alejandra¹ aramos@fundacio-puigvert.es, de la Sierr, Alejandro², Oliveras, Anna³, Armario, Pedro⁴, Ayasreh, Nadia¹, Arias, Piedad¹, Vázquez, Susana³, Camps, Carme³, Castellanos, Pere⁴, Calero, Francesca¹, Fernández-Llama, Patricia¹
Source:	Nefrologia. Jun/Jul2026, Vol. 46 Issue 6, p1-7. 7p.
Subjects:	ORTHOSTATIC hypotension, KIDNEY injuries, ARTERIAL diseases, LEFT ventricular hypertrophy, HYPERTENSION
Abstract (English):	Background: Blood pressure (BP) exhibits specific characteristics in elderly patients. We evaluated the association between positional BP changes during orthostatism and the presence of hypertension-mediated target organ damage (HMOD) in functionally preserved elderly hypertensive patients. Methods: This was a multicenter, cross-sectional study of 156 hypertensive patients with a mean age of 75 ± 5.8 years (49% women). Central and peripheral office and 24-hour BP were measured using an oscillometric device. Orthostatic BP changes were recorded according to the conventional definition of orthostatic hypotension (OH) and also as a continuous variable obtained by subtracting values (supine BP – orthostatic BP). Treating BP as a continuous variable, patients were divided into two groups based on orthostatic BP changes, below or above the median of the distribution. HMOD was assessed as renal (reduced glomerular filtration rate and/or increased albuminuria), cardiac [left ventricular hypertrophy (LVH)], and arterial (increased aortic pulse wave velocity). Results: OH was present in 33 patients (21%), whereas orthostatic BP change showed a wide distribution. A total of 145 patients (92.9%) presented HMOD (48% kidney disease, 47% LVH, and 81% arterial stiffness). All patients with OH showed HMOD involvement and significantly higher values of all systolic BP estimates. Although OH and HMOD were not significantly associated, analysis of orthostatic BP changes showed greater renal damage in the group with a BP reduction above the median compared with those with a reduction below it, after adjustment for age, office BP, and alpha-blocker treatment (p < 0.05). Conclusion: Orthostatic BP reduction is associated with renal damage in functionally preserved elderly hypertensive patients. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Antecedentes: La presión arterial (PA) presenta características específicas en pacientes de edad avanzada. Evaluamos la asociación de los cambios posicionales en la PA durante el ortostatismo con la presencia de lesión de órgano diana mediada por hipertensión (LODMH) en pacientes ancianos hipertensos con buen estado funcional. Métodos: Este fue un estudio multicéntrico y transversal de 156 pacientes hipertensos con una edad de 75 ± 5,8 años (49% mujeres). La PA central y periférica en consulta y durante 24 horas se midió con un dispositivo oscilométrico. Los cambios de PA inducidos por la posición de pie se registraron en base a la definición convencional de hipotensión ortostática (HO) y también como una variable continua, resultado de la resta de los valores de PA en decúbito - PA ortostática. Tomando este valor de PA como variable continua, se distribuyó a los pacientes en dos grupos en función de los cambios ortostáticos de PA, por debajo o por encima de la mediana de la distribución. La LODMH se evaluó como renal (reducción de la tasa de filtración glomerular y/o aumento de la albuminuria), cardiaca (hipertrofia ventricular izquierda [HVI]) y arterial (incremento de la velocidad de la onda de pulso aórtica [VOPa]). Resultados: La HO estuvo presente en 33 pacientes (21%), mientras que el cambio ortostático de PA mostró una amplia distribución. Un total de 145 pacientes (92,9%) presentaron LODMH (48% enfermedad renal, 47% HVI y 81% rigidez arterial). Todos los pacientes con HO mostraron LODMH y valores significativamente más elevados de todas las estimaciones de PA sistólica. Aunque la HO y la LODMH no se asociaron de forma significativa, el análisis de los cambios ortostáticos de PA mostró un mayor daño renal en el grupo con una reducción de PA por encima de la mediana, en comparación con aquellos con una reducción por debajo de ella, tras ajustar por edad, PA en consulta y tratamiento con alfa-bloqueantes (p < 0,05). Conclusión: La reducción ortostática de la PA se asocia con daño renal en pacientes ancianos hipertensos con buen estado funcional. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Background: Blood pressure (BP) exhibits specific characteristics in elderly patients. We evaluated the association between positional BP changes during orthostatism and the presence of hypertension-mediated target organ damage (HMOD) in functionally preserved elderly hypertensive patients. Methods: This was a multicenter, cross-sectional study of 156 hypertensive patients with a mean age of 75 ± 5.8 years (49% women). Central and peripheral office and 24-hour BP were measured using an oscillometric device. Orthostatic BP changes were recorded according to the conventional definition of orthostatic hypotension (OH) and also as a continuous variable obtained by subtracting values (supine BP – orthostatic BP). Treating BP as a continuous variable, patients were divided into two groups based on orthostatic BP changes, below or above the median of the distribution. HMOD was assessed as renal (reduced glomerular filtration rate and/or increased albuminuria), cardiac [left ventricular hypertrophy (LVH)], and arterial (increased aortic pulse wave velocity). Results: OH was present in 33 patients (21%), whereas orthostatic BP change showed a wide distribution. A total of 145 patients (92.9%) presented HMOD (48% kidney disease, 47% LVH, and 81% arterial stiffness). All patients with OH showed HMOD involvement and significantly higher values of all systolic BP estimates. Although OH and HMOD were not significantly associated, analysis of orthostatic BP changes showed greater renal damage in the group with a BP reduction above the median compared with those with a reduction below it, after adjustment for age, office BP, and alpha-blocker treatment (p < 0.05). Conclusion: Orthostatic BP reduction is associated with renal damage in functionally preserved elderly hypertensive patients. [ABSTRACT FROM AUTHOR]
ISSN:	02116995
DOI:	10.1016/j.nefro.2026.501521