Postural blood pressure changes in the elderly

1. 1. In a group of 250 ambulatory aged persons, marked falls in systolic blood pressure (more than 62 mm. Hg) or of diastolic blood pressure (more than 40 mm. Hg) were not found on change from the recumbent to the standing position. In no case did the level on standing fall to below 90 mm. Hg systolic over 54 mm. Hg diastolic. 2. 2. Mild but abnormal falls of the systolic and diastolic blood pressure levels on standing were frequent. 3. 3. A high incidence of marked varicose veins and thrombophlebitis was found in the group with falls of more than 20 mm. in systolic pressure on standing. 4. 4. Symptoms such as weakness, dizziness, and headaches, commonly attributed to orthostatic variations of the blood pressure, were frequent but had no relationship to the occurrence of appreciable falls in blood pressure on standing or to the occurrence of elevated resting blood pressure. 5. 5. Symptoms such as dizziness and headaches, commonly attributed to hypertension, were frequent but had no relationship to the resting level of the blood pressures. 6. 6. The lack of correlation between the symptoms studied here, which are commonly attributed either to hypertension or to orthostatic changes in the blood pressure, and the actual physical findings in our series emphasize the need for caution in the interpretation and explanation of untoward subjective sensations in older patients.