Background Initial orthostatic hypotension (OH) is a clinical syndrome of exaggerated transient orthostasis associated with higher risks of falls, frailty and syncope in older adults. Objective To provide a prevalence estimate of initial OH in adults aged 65 years or older. Methods Literature search of MEDLINE (from 1946), Embase (from 1947) and Cochrane Central Register of Controlled Trials was performed until 6 December 2019, using the terms ‘initial orthostatic hypotension’, ‘postural hypotension’ and ‘older adults’. Articles were included if published in English and participants were 65 years or older. Random effects models were used for pooled analysis. Results Of 5,136 articles screened, 13 articles (10 cross-sectional; 3 longitudinal) reporting data of 5,465 individuals (54.5% female) from the general (n = 4,157), geriatric outpatient (n = 1,136), institutionalised (n = 55) and mixed (n = 117) population were included. Blood pressure was measured continuously and intermittently in 11 and 2 studies, respectively. Pooled prevalence of continuously measured initial OH was 29.0% (95% CI: 22.1–36.9%, I2 = 94.6%); 27.8% in the general population (95% CI: 17.9–40.5%, I2 = 96.1%), 35.2% in geriatric outpatients (95% CI: 24.2–48.1%, I2 = 95.3%), 10.0% in institutionalised individuals (95% CI: 2.4–33.1%, I2 = 0%) and 21.4% in the mixed population (95% CI: 7.0–49.6, I2 = 0%). Pooled prevalence of intermittently measured initial OH was 5.6% (95% CI: 1.5–18.9%, I2 = 81.1%); 1.0% in the general population (95% CI: 0.0–23.9%, I2 = 0%) and 7.7% in geriatric outpatients (95% CI: 1.8–27.0%, I2 = 86.7%). Conclusion The prevalence of initial OH is high in older adults, especially in geriatric outpatients. Proper assessment of initial OH requires continuous blood pressure measurements.

中文翻译：

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老年人初始体位性低血压的患病率：系统评价和荟萃分析

背景 初始体位性低血压 (OH) 是一种夸大的短暂体位性临床综合征，与老年人跌倒、虚弱和晕厥的风险较高相关。目的 提供 65 岁或以上成年人初始 OH 的患病率估计值。方法 使用术语“初始体位性低血压”、“体位性低血压”和“老年人”对 MEDLINE（1946 年起）、Embase（1947 年起）和 Cochrane Central Register of Controlled Trials 进行文献检索，直至 2019 年 12 月 6 日。如果以英语发表且参与者年龄在 65 岁或以上，则文章将被纳入。随机效应模型用于汇总分析。结果 在筛选的 5,136 篇文章中，13 篇文章（10 篇横断面；3 篇纵向）报告了来自一般（n = 4,157）的 5,465 人（54.5% 女性）的数据，包括老年门诊（n = 1,136）、机构化（n = 55）和混合（n = 117）人群。分别在 11 项和 2 项研究中连续和间歇地测量血压。连续测量的初始 OH 的汇总患病率为 29.0%（95% CI：22.1-36.9%，I2 = 94.6%）；一般人群中为 27.8%（95% CI：17.9–40.5%，I2 = 96.1%），老年门诊患者中为 35.2%（95% CI：24.2–48.1%，I2 = 95.3%），机构化个体中为 10.0%（95 % CI：2.4–33.1%，I2 = 0%）和混合人群中的 21.4%（95% CI：7.0–49.6，I2 = 0%）。间歇性测量的初始 OH 的汇总患病率为 5.6%（95% CI：1.5-18.9%，I2 = 81.1%）；一般人群中为 1.0%（95% CI：0.0-23.9%，I2 = 0%），老年门诊患者中为 7.7%（95% CI：1.8-27.0%，I2 = 86.7%）。结论 老年人初始 OH 患病率较高，尤其是老年门诊患者。正确评估初始 OH 需要连续测量血压。