Clark et al reported the DROP (Detecting Risk Of Postural hypotension) score to identify patients at risk for postural hypotension. The authors are from the University of Exeter and the National Institute on Aging in Baltimore.
Population: 15% with postural hypotension
Criteria for postural hypotension - one of the following:
(1) drop of systolic blood pressure >= 20% within 3 minutes of standing up
(2) drop of diastolic blood pressure >= 10% within 3 minutes of standing up
Parameters:
(1) digoxin therapy
(2) Parkinson's disease
(3) hypertension
(4) cardiovascular disease
(5) stroke
(6) interarm difference in systolic blood pressures
Parameter
Finding
Points
digoxin therapy
no
0
yes
1
Parkinson's disease
no
0
yes
1
hypertension
no
0
yes
1
cardiovascular disease
no
0
yes
1
stroke
no
0
yes
1
interarm difference SBP
< 10 mm Hg
0
>= 10 mm Hg
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A score >=1 was associated with an increased risk of postural hypotension.
• The risk of mortality increased as the score increased.
Score
Percent with Postural Hypotension
0
7%
1
21%
2
17%
3
36%
4
100%
Performance:
• The area under the ROC curve is 0.65.
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