ArticleBMJ open2018
Detecting Risk Of Postural hypotension (DROP): derivation and validation of a prediction score for primary care.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Prevalence of postural hypotension in primary, community and institutional care: a systematic review and meta-analysis.BMC family practice · 2021Pooled it
- Understanding measurement of postural hypotension: a nationwide survey of general practice in England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Drug-Induced Orthostatic Hypotension in UK Primary Care: A Self-Controlled Case Series Study.Clinical epidemiology · 2026Article
- Predicting hypotension, syncope, and fracture risk in patients indicated for antihypertensive treatment: the STRATIFY models.Nature communications · 2025Article
- Machine-learning model for the prediction of acute orthostatic hypotension after levodopa administration.CNS neuroscience & therapeutics · 2024Article
- Hypertension and hypotension: getting the balance right.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Addressing Orthostatic Hypotension in Heart Failure: Pathophysiology, Clinical Implications and Perspectives.Journal of cardiovascular translational research · 2020Review
- Systolic inter-arm blood pressure difference and risk of cognitive decline in older people: a cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Association between Orthostatic Hypotension and Frailty in Hospitalized Older Patients: a Geriatric Syndrome More Than a Cardiovascular Condition.The journal of nutrition, health & aging · 2019Observational
- Health and Functional Determinants of Orthostatic Hypotension in Geriatric Ward Patients: A Retrospective Cross Sectional Cohort Study.The journal of nutrition, health & aging · 2019Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesFalls are a common problem in older people. Postural hypotension contributes to falls but is often asymptomatic. In the absence of symptoms, postural hypotension is only infrequently checked for in clinical practice. We undertook this study to derive, validate and explore the prospective associations of a prediction tool to identify people likely to have unrecognised postural hypotension. DESIGN AND
settingCross-sectional and prospective multivariable cohort analysis.
participants1317 participants of the Invecchiare in Chianti study, a population-based cohort representative of the older Italian population. PRIMARY OUTCOME MEASURES: Predictive value of score to suggest presence of postural hypotension.
methodsSubjects were randomised 1:1 to derivation or validation cohorts. Within the derivation cohort, univariable associations for candidate predictors of postural hypotension were tested. Variables with p<0.1 entered multivariable linear regression models. Factors retaining multivariable significance were incorporated into unweighted and weighted Detecting Risk Of Postural hypotension (DROP) scores. These scores were tested in the validation cohort against prediction of postural hypotension, cognitive decline and mortality over 9 years of follow-up.
resultsPostural hypotension was present in 203 (15.4%) of participants. Factors predicting postural hypotension were: digoxin use, Parkinson's disease, hypertension, stroke or cardiovascular disease and an interarm systolic blood pressure difference. Area under the curve was consistent at 0.65 for all models, with significant ORs of 1.8 to 2.4 per unit increase in score for predicting postural hypotension. For a DROP score ≥1, five cases need to be tested to identify one with postural hypotension.Increasing DROP scores predicted mortality (OR 1.8 to 2.8 per unit rise) and increasing rates of decline of Mini Mental State Examination score (analysis of variance p<0.001) over 9 years of follow-up.
conclusionsThe DROP score provides a simple method to identify people likely to have postural hypotension and increased risks to health who require further evaluation.
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