A Comparative Study on Orthostatic Hypotension in Hypertensive and Non-Hypertensive Elderly Patients

Introduction: Orthostatic hypotension (OH) is a common but often under-recognized condition in the elderly, associated with significant morbidity including falls and syncope. Hypertension and its treatment may further predispose individuals to OH. This study aimed to compare the prevalence of orthostatic hypotension among hypertensive and non-hypertensive elderly patients and to evaluate its associated factors. Materials and Methods: A hospital-based comparative cross-sectional study was conducted at Mamata Medical College, Khammam, from November 2024 to November 2025. A total of 100 elderly patients aged ≥60 years were included and divided into hypertensive (n=50) and non-hypertensive (n=50) groups. Blood pressure was measured in supine and standing positions, and OH was defined as a fall in systolic BP ≥20 mmHg and/or diastolic BP ≥10 mmHg. Data were analyzed using appropriate statistical tests, with p<0.05 considered significant. Results: The overall prevalence of OH was 38.0%. It was significantly higher in hypertensive patients (52.0%) compared to non-hypertensive patients (24.0%) (p=0.003). The prevalence of OH increased with age, showing a significant association (p=0.041). No significant association was observed with gender (p=0.82). Among OH cases, mild severity was most common (47.4%). Dizziness (63.2%) and giddiness (52.6%) were the predominant symptoms. Conclusion: Orthostatic hypotension is highly prevalent among elderly individuals, particularly in those with hypertension and advancing age. Routine screening for OH in elderly hypertensive patients is essential for early detection and prevention of complications.