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Orthostatic Hypotension is a common medical condition among older adults which can cause dizziness, light-headedness, and fainting when a person stands up.  It is diagnosed when systolic blood pressure (the top number in a blood pressure reading) drops by at least 20mm Hg during transition of lying down to standing up or sitting to standing up, or when diastolic blood pressure (the bottom number) drops by at least 10 mmHg. 

Aspire Clinical Intelligence is excited to work with nursing teams to reduce falls that occur due to orthostatic hypotension.  During the first quarter of 2022, we have integrated hypostatic blood pressure checks into our software, prompting nurses to check them when a resident has certain indicators, including the use of antihypertensive medications.

According to an April 2014 study, antihypertensive medications were associated with an increased risk of serious fall injuries, particularly among those with previous fall injuries.  The potential harms vs benefits of antihypertensive medications should be weighed in deciding to continue treatment with those medications in older adults with multiple chronic conditions. (Mary E. Tinetti, 2014) 

The two most probable mechanisms by which antihypertensive medications increase fracture risk are (1) falls related to relative hypotension, and (2) direct effects on bone metabolism that decrease bone marrow density over a more prolonged period.  According to a 2011 study, many antihypertensive medications have been linked to osteoporosis and fractures, but fracture risk varied significantly across antihypertensive categories.  Thiazide diuretics and angiotensin-receptor blockers were consistently associated with reduced fracture risk compared with calcium channel blockers. (Solomon, 2011)

However, there is good news. Treatments are available for patients diagnosed with orthostatic hypotension.  These treatments include physical therapy to improve balance, lifestyle changes including drinking more fluid and eating smaller meals, and changing or stopping medications that are thought to be associated with orthostatic hypotension.  Patients should work with their primary care provider to find the treatment that will work best for their individual needs.

In short, we know that orthostatic hypotension may be a contributing factor to resident falls.  Early detection and treatment could reduce the likelihood of a fall occurrence for many assisted living and memory care residents.  Aspire Clinical Intelligence is helping assisted living and memory care communities intervene sooner to reduce resident falls.

If you would like to learn more about the software Aspire Clinical Intelligence is utilizing to monitor orthostatic hypotension, please reach out to us at info@aspireci.com.

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