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Lee and Kim: Effects of Tailored Water Drinking on the Orthostatic Hypotension in the Elderly
Original Article

Korean J Adult Nurs 2014;26(3):341-351.

Published online: NaN June 2014

DOI: https://doi.org/10.7469/kjan.2014.26.3.341

Effects of Tailored Water Drinking on the Orthostatic Hypotension in the Elderly

Eunjoo Lee1, Eun Hee Kim2,

1College of Nursing ․ Research Institute of Nursing Science, Kyungpook National University, Daegu

2Department of Nursing, Suseong College, Daegu, Korea

Corresponding author: Kim, Eun Hee Department of Nursing, Suseong College, 15 Dalgubeol-daero 528-gil, Suseong-gu, Daegu 706-711, Korea. Tel: +82-53-749-7247, Fax: +82-53-749-7240, E-mail: kkkeh35@hanmail.net

This work was supported by the National Research Foundation of Korea Grant funded by the Korean Government (2013S1A5A2A03044389).

Received 8 August 201327 May 2014       Accepted 4 June 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of the study was to examine preventive effects of tailored water drinking on orthostatic hypotension and heart rate variability in the elderly.

Methods

A non-equivalent control group pre and post time-series design was adapted. Among a total of 64 elderly people admitted to two nursing homes, 35 elderly were assigned to the experimental group and 29 were assigned to the control group. As for the elderly people in the experimental group, tailed water drink was provided according to the scheduled time for six weeks. Blood pressure and heart rate were measured twice before the intervention in both groups. The data were analyzed with SPSS program using t-test, x2-test, and repeated measure of ANOVA.

Results

There were significant differences in blood pressure and heart rate variability between the two groups.

Conclusion

Tailored water drinking had preventive effects on decreasing blood pressure fall as well as prevalence of orthostatic hypotension in the elderly people.

Keywords: Elderly, Orthostatic hypotension, Heart rate, Water

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Table 1.
Homogeneity Test for General Characteristics between Two Groups (N=63)
Characteristics Categories   Exp. (n=29) Cont. (n=34) x2 or t p
n (%) or M±SD n (%) or M±SD
Age (year)⁎ 65~74   4 (13.8) 11 (32.4) 3.40 .183
75~84   14 (48.3) 15 (44.1)
≥85   11 (37.9) 8 (23.5)
  82.2±7.85 78.4±7.47 2.01 .049
Gender Female   28 (96.6) 16 (47.1) 18.20 ＜.001
Male   1 (3.4) 18 (52.9)
Education level⁎ Illiteracy   20 (69.0) 10 (29.4) 11.12 .004
Elementary   8 (27.6) 16 (47.1)
≥Middle school   1 (3.5) 8 (23.5)
Religion Yes   18 (62.1) 15 (44.1) 2.02 .155
No   11 (37.9) 19 (55.9)
No. of co-morbidity in past (numbers) ＜4   16 (55.2) 22 (64.7) 0.59 .441
≥4   13 (44.8) 12 (35.3)  
    3.28±1.00 2.82±1.03 1.77 .083
No. of co-morbidity in current (numbers) ＜4   27 (93.1) 33 (97.1) 0.54 .463
≥4   2 (6.9) 1 (2.9))  
    2.10±1.11 1.82±0.87 1.12 .267
Length of stay (year) ＜2   9 (31.0) 17 (50.0) 4.77 .092
2~4   9 (31.0) 12 (35.3)
≥4   11 (37.9) 5 (14.7)  
    3.50±1.94 2.17±1.23 3.16 .003
Water intake (mL/24 hr) AWI   911.0±201.3 901.6±201.3 0.20 .845
Expected water intake (mL/24 hr) AWI   1,865 1,900    
BP/HR (mmHg/BPM) Degree of drop SBP -11.9±7.00 -12.2±7.67 0.14 .887
  DBP -5.1±5.99 -8.5±5.95 1.78 .080
  HR -3.2±3.68 -2.9±4.71 -0.25 .806
Body weight (kg)   ＜39 8 (27.6) 3 (8.8) 4.20 .122
  40~49 14 (48.3) 18 (52.9)
  ≥50 7 (24.1) 13 (38.2)

Exp.=experimental group; Cont.=control group; AWI=average amount of water iitake per day; BP=blood pressure; SBP=systolic blood pressure; DBP=diastolic blood pressure; HR=heart rate; BPM=beat per minute; Fisher's exact test (p).

Table 2.
Average Fluid Intake and Urine Output by Weeks between Two Groups (N=63)
Variables Groups 1 wk 2 wk 3 wk 4 wk 5 wk 6 wk
M±SD M±SD M±SD M±SD M±SD M±SD
Fluid intake Exp. (n=29) 1,884±306.1 1,917±270.5 1,859±233.6 1,901±245.2 1,913±267.3 1,887±272.5
  Cont. (n=34) 665±131.5 713±129.5 715±129.5 594±131.7 594±131.0 506±131.9
Urine output Exp. (n=29) 1,887±320.2 1,920±271.9 1,916±332.1 1,896±241.2 1,972±486.2 1,881±258.4
  Cont. (n=34) 768±133.1 773±170.7 763±129.7 453±130.6 584±133.9 360±132.1

Exp.=experimental group; Cont.=control group.

Table 3.
Degree of Blood Pressure and Heart Rate Change between Two Groups (N=63)
Variables Groups Intervention Source p
1 wk 2 wk 3 wk 4 wk 5 wk 6 wk
M±SD M±SD M±SD M±SD M±SD M±SD
OH SBP Exp. (n=29) -12.8±7.00 -11.0±8.23 -6.2±9.79 -9.7±6.18 -9.0±5.30 -5.5±7.39 Group ＜.001
(mmHg) Cont. (n=34) -11.1±7.67 -13.2±8.24 -10.9±7.93 -17.4±11.63 -15.0±10.80 -18.8±8.44 Time .014
  t (p) -0.71 (.478) -0.98 (.331) -2.10 (.040) -3.38 (.001) -2.77 (.008) -6.61 (＜.001) GT ＜.001
OH DBP Exp. (n=29) -7.9±5.99 -6.2±5.59 -7.2±6.32 -4.5±6.88 -4.8±3.71 -5.5±6.32 Group .001
(mmHg) Cont. (n=34) -7.4±5.95 -10.6±8.34 -11.8±9.96 -9.1±8.53 -10.0±8.46 -12.1±8.80 Time .290
  t (p) 0.32 (.748) -1.99 (.050) -2.19 (.032) -2.16 (.035) -2.62 (.011) -3.34 (.001) GT .117
OHR Exp. (n=29) -3.9±3.68 0.8±6.02 0.3±3.23 0.8±3.30 1.7±6.85 1.7±3.06 Group ＜.001
(BPM) Cont. (n=34) -2.0±4.71 1.1±7.79 5.3±3.90 8.2±5.37 5.9±11.80 11.3±9.74 Time ＜.001
  t (p) 1.46 (.150) 1.28 (.206) 4.02 (＜.001) 6.73 (＜.001) 1.69 (.055) 5.09 (＜.001) GT .003

Exp.=experimental group; Cont.=control group;; OH=orthostatic hypotension SBP=systolic blood pressure; DBP=diastolic blood pressure; OHR=orthostatic heart rate; BPM=beat per minute.

Table 4.
Degree of Blood Pressure and Heart Rate Change between Two Groups (N=63)
Variables Reduce of vital sign Intervention
1 wk 2 wk 3 wk 4 wk 5 wk 6 wk
Exp. Cont. Exp. Cont. Exp. Cont. Exp. Cont. Exp. Cont. Exp. Cont.
n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)
OH SBP (mmHg) ≤-20 12 (41.4) 13 (38.2) 13 (44.8) 14 (41.2) 9 (31.0) 20 (58.8) 2 (6.9) 19 (55.9) 2 (6.9) 18 (52.9) 1 (3.4) 26 (76.5)
-10~-19 11 (37.9) 13 (38.2) 9 (31.0) 16 (47.1) 13 (44.8) 10 (29.4) 24 (82.8) 10 (29.4) 21 (72.4) 10 (29.4) 17 (58.6) 5 (14.7)
0~-9 6 (20.7) 5 (14.7) 5 (17.2) 4 (11.8) 6 (20.7) 4 (11.8) 3 (10.3) 5 (14.7) 6 (20.7) 5 (14.7) 8 (27.6) 3 (8.8)
≥1 0 (0.0) 3 (8.8) 2 (6.9) 0 (0.0) 1 (3.4) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (2.9) 3 (10.3) 0 (0.0)
Fisher's exact test (p) 2.60 (.494) 3.38 (.315) 5.51 (.103) 26.21 (＜.001) 18.34 (＜.001) 6.23 (.030)
OH DBP (mmHg) ≤-10 21 (72.4) 20 (58.8) 14 (48.3) 23 (67.6) 15 (51.7) 26 (76.5) 11 (37.9) 22 (64.7) 13 (44.8) 25 (73.5) 14 (48.3) 29 (85.3)
0~-9 8 (27.6) 11 (32.4) 12 (41.4) 11 (32.4) 12 (41.4) 8 (23.5) 18 (62.1) 10 (29.4) 15 (51.7) 8 (23.5) 15 (51.7) 5 (14.7)
≥1 0 (0.0) 3 (8.8) 3 (10.3) 0 (0.0) 2 (6.9) 0 (0.0) 0 (0.0) 2 (5.9) 1 (3.4) 1 (3.4) 0 (0.0) 0 (0.0)
Fisher's exact test (p) 2.74 (.280) 4.45 (.080) 0.14 (.467) 7.13 (.016) 5.71 (.041) 9.90 (.002)
OHR (BPM) ≤-20 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (3.4) 0 (0.0) 0 (0.0) 0 (0.0)
-10~-19 1 (3.4) 4 (11.8) 2 (6.9) 2 (5.9) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 3 (8.8) 0 (0.0) 1 (2.9)
-9~9 28 (96.6) 29 (85.3) 27 (93.1) 27 (79.4) 29 (100.0) 24 (70.6) 28 (96.6) 20 (58.8) 27 (93.1) 18 (52.9) 29 (100.0) 15 (44.1)
10~19 0 (0.0) 1 (2.9) 0 (0.0) 4 (11.8) 0 (0.0) 10 (29.4) 1 (3.4) 14 (41.2) 1 (3.4) 9 (26.5) 0 (0.0) 11 (32.4)
≥20 0 (0.0) 0 (0.0) 0 (0.0) 1 (2.9) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 4 (11.8) 0 (0.0) 7 (20.6)
Fisher's exact test (p) 2.44 (.296) 4.63 (.201) 10.14 (.001) 12.28 (＜.001) 15.90 (.003) 23.20 (＜.001)

Exp.=experimental group; Cont.=control group;; OH=orthostatic hypotension; SBP=systolic blood pressure; DBP=diastolic blood pressure; OHR=orthostatic heart rate; BPM=beat per minute.

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