Orthostatic Hypotension In The Elderly And Its Correlation With Serum Levels Of MMP-9

ObjectivesTo investigate the prevalence of orthostatic hypotension(OH) in the elderly, to explore the relationship between OH and serum levels of matrix metalloproteinase-9(MMP-9). MethodsFrom September 2015 to December 2015, 653 elderly patients were selected from inpatient, outpatient and who took physical examination in Fujian provincial hospital. Finished the basic data collection, laboratory examination, orthostatic blood pressure measurement and the serum level of MMP-9 detection. Used the chi-square test to compare the incidence of OH. The multiple linear regression analysis was applied to explore the relationship between the change values of blood pressure and supine blood pressure, and the binary logistic regression analysis was applied to explore the risk factors of OH and its relationship with serum levels of MMP-9. Results1. The prevalence of OH in the total study population was 25.4%, and increased with the increasing in age(P<0.05). The prevalence of OH in≥80-year-old group and<80-year-old group was 30.3% and 2.3% respectively, the differences were significant(P<0.05). There is no difference in prevalence of OH between hypertension group and non-hypertension group(P > 0.05), but the prevalence of OH increased with the increasing in systolic blood pressure and diastolic blood pressure in the supine position(P<0.01).2. The prevalence of OH in hypertension population was 25.7%, and no significant correlation with age(P>0.05). The prevalence of OH in good blood pressure control group and poor blood pressure control group was 30.7% and 19.2% respectively, the differences were significant(P<0.05). The prevalence of OH increased with the increasing in supine diastolic blood pressure(P<0.01), but no similar findings in supine systolic blood pressure(P>0.05).3. Multiple linear regression analysis showed that, the variations of systolic blood pressure in 1min and 3min were positively correlated with supine systolic blood pressure; the variations of diastolic blood pressure in 1min and 3min were positively correlated with supine diastolic blood pressure(P<0.01).4. The age, low density lipoprotein cholesterol(LDL-C), serum uric acid level had significantly difference in OH and non-OH group(P<0.05); Binary logistic regression analysis confirmed that, the age greater than or equal to 80 years, poorly controlled in systolic blood pressure, poorly controlled in diastolic blood pressure brought 1.555, 1.642, 1.741 times greater risk of OH respectively.5. The level of Ln(MMP-9) in OH group and non-OH group were 6.04±0.49ng/mL and 6.21±0.50ng/mL respectively, the differences were significant(P<0.05). The level of Ln(MMP-9) in OH-S group were lower than those of non-OH-S(P<0.05). There was no statistic significance between OH-D group and non-OH-D group, or OH-C group and non-OH-C group in the level of Ln(MMP- 9)(P>0.05).6. Pearson correlation analysis showed that the level of Ln(MMP- 9) was not associated with the variations of orthostatic blood pressure(P>0.05). Binary logistic regression analysis confirmed that, a unit elevated of Ln(MMP- 9) lead to 0.519 times lower risk of OH. ConclusionsThe prevalence of OH in the total study population was 25.4%, and increased with the increasing in age, supine systolic blood pressure and diastolic blood pressure. The variations of orthostatic blood pressure were positively correlated with supine blood pressure. The negative relationship was found in the Ln(MMP- 9) and OH.