Eight orthostatic haemodynamic patterns in The Irish Longitudinal Study on Ageing (TILDA): stability and clinical associations after 4 years

Abstract

Previous research cross-sectionally characterised eight morphological systolic blood pres-sure (SBP) active stand (AS) patterns using a clinical clustering approach at Wave 1 (W1) of the IrishLongitudinal Study on Ageing. We explored the longitudinal stability and clinical associations ofthese groupings at Wave 3 (W3), four years later. Eight AS groups had their clinical characteristicsand AS patterns at W3 compared to W1. We explored longitudinal associations (new cognitivedecline, falls, syncope, disability, and mortality) using multivariate logistic regression models. Intotal, 2938 participants (60% of Wave 1 sample) had adequate AS data from both W1 and 3 foranalysis. We found no longitudinal stability of the eight AS groups or their morphological patterns between the waves. A pattern of impaired stabilisation and late deficit seemed more preserved and was seen in association with new cognitive decline (OR 1.63, 95% CI: 1.12–2.36,p= 0.011). An increase in antihypertensive usage seemed associated with reduced immediate SBP drops, improved AS patterns, and reduced orthostatic intolerance (OI). In pure longitudinal groups, AS patterns were not preserved after 4 years. AS patterns are longitudinally dynamic, and improvements after 4 years are possible even in the presence of higher antihypertensive burden.