Unprovoked and glyceryl trinitrate-provoked head-up tilt table test is safe in older people: A review of 10 years' experience

Objectives: To test the safety of the head-up tilt test (HUT) in older adults. Design: Direct observation and measurements. Setting: Tests performed in a quiet room with dim lighting in a laboratory setting. Participants: One thousand ninety-six subjects aged 60 to 74; 873 aged 75 and older. Measurements: Blood pressure and pulse at baseline for 10 minutes and 70degrees tilt for maximum of 45 minutes. Subjects with unprovoked HUT had test repeated on a separate day after 800 mg glyceryl trinitrate (GTN). Results: One thousand four hundred ninety-five drug-free and 474 GTN-provoked HUTs were studied. In those aged 60 to 74, the proportion of hypotensive unprovoked HUT was 16% (27% in those aged greater than or equal to75); this was higher with GTN provocation (43% in those aged 60-74, 44% in those aged greater than or equal to75; P<.01). Systolic blood pressure decreased during provoked HUT (lowest mean+/-standard deviation=67+/-20 in those aged 60-74, 63+/-24 in those aged greater than or equal to75; P<.01). There was one cardiovascular and no neurological complications. Conclusion: This study included 10 times as many people as previous studies and demonstrates the safety of HUT in older people.