Sit-up test for assessing impaired blood pressure regulation in community-dwelling older adults: a cross-sectional study

Kazuaki Oyake; Yoshiharu Yokokawa

doi:10.1186/s12877-025-06456-w

. 2025 Oct 8;25:764. doi: 10.1186/s12877-025-06456-w

Sit-up test for assessing impaired blood pressure regulation in community-dwelling older adults: a cross-sectional study

Kazuaki Oyake ^1,^✉, Yoshiharu Yokokawa ¹

PMCID: PMC12505652 PMID: 41062976

Abstract

Background

The sit-up test enables safe orthostatic hypotension assessment without using a tilt table in high fall-risk individuals; however, no study has compared blood pressure responses between older adults with and without orthostatic hypotension during this test. The primary objective was to compare blood pressure responses during the sit-up test between community-dwelling older adults with and without orthostatic hypotension as defined by this test. The secondary objective was to determine the associations between orthostatic hypotension detected by the sit-up test and adverse health outcomes in these individuals.

Methods

This was a cross-sectional study; thus, it cannot establish causality. One hundred two community-dwelling older adults underwent the sit-up test. Orthostatic hypotension was defined as a decrease of ≥ 10 mmHg in systolic blood pressure and/or ≥ 5 mmHg in diastolic blood pressure during the test. Supine and seated hypertension were defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Blood pressure responses during the test were compared between participants with and without orthostatic hypotension. Moreover, independent associations between orthostatic hypotension and adverse health outcomes were examined.

Results

Thirty-four participants (33.3%) experienced orthostatic hypotension. Participants with orthostatic hypotension demonstrated a greater decrease in systolic blood pressure (F_(3,297) = 47.0, p < 0.001), smaller increase in diastolic blood pressure (F_(3,297) = 26.5, p < 0.001), and higher supine systolic blood pressure (t = 3.363, p = 0.005) than those without orthostatic hypotension. Accordingly, 52.9% of the participants with orthostatic hypotension had supine hypertension. Orthostatic hypotension was associated with a higher proportion of participants with at least one comorbidity (odds ratio = 4.50, p = 0.002) and those with a pre-frail or frail status (odds ratio = 3.08, p = 0.022), even after adjusting for supine and seated hypertension.

Conclusion

Community-dwelling older adults with orthostatic hypotension were characterized by an impaired increase in diastolic blood pressure during sitting up and high supine systolic blood pressure. Orthostatic hypotension was associated with adverse health outcomes, independent of supine and seated hypertension. These findings provide valuable insights for the application of the sit-up test in preventive health screenings for older adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-025-06456-w.

Keywords: Blood pressure, Comorbidity, Frailty, Geriatric assessment, Hypertension, Orthostatic hypotension, Rehabilitation

Background

Blood pressure management in older adults requires careful consideration of the various physiological changes associated with aging. Hypertension, defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg in the sitting position (seated hypertension), is a major risk factor for mortality and cardiovascular disease [1]. These relationships are partly mediated by arterial stiffness, which reduces baroreflex sensitivity [2]. Conventional seated blood pressure measurement remains the standard practice in routine health screenings; however, this single-position assessment may not fully capture impaired blood pressure regulation. Specifically, impaired blood pressure regulation is attributed to impaired baroreflex function with an increasing prevalence with age, potentially resulting in orthostatic hypotension (OH) and supine hypertension, along with seated hypertension [2, 3].

OH, defined as a sustained decrease in systolic blood pressure of ≥ 20 mmHg or diastolic blood pressure of ≥ 10 mmHg within 3 min of standing or head-up tilt, is a common manifestation of impaired blood pressure regulation that is associated with increased risks of mortality and morbidity, including falls, dementia, cardiovascular diseases, and stroke, independent of hypertension [4–11]. The prevalence of OH increases with age, affecting 22.2% (95% confidence interval = 17–28) of community-dwelling older adults [12]. Moreover, approximately 50% of individuals with OH have supine hypertension, defined as a systolic blood pressure of ≥ 140 mmHg and/or diastolic blood pressure of ≥ 90 mmHg in the supine position [13–15]. Supine hypertension is reportedly associated with a high risk of heart failure, stroke, and all-cause mortality, regardless of OH status [15].

The sit-up test is designed to assess OH in individuals who are unable to stand independently or are at a high risk of falling when standing [16–19]. Blood pressure reduction elicited during sitting up is smaller than that elicited during standing up owing to reduced acute changes in gravitational stress [19]. Therefore, a previous study established specific cutoff points for the sit-up test that correspond to the consensus definitions of OH. Specifically, a decrease of ≥ 10 mmHg in systolic blood pressure during the sit-up test can identify individuals with a systolic blood pressure reduction of ≥ 20 mmHg during the head-up tilt test with high diagnostic accuracy (area under the curve of 0.915, sensitivity of 87.5%, and specificity of 96.7%). Similarly, a reduction of ≥ 5 mmHg in diastolic blood pressure during the sit-up test can detect individuals with a diastolic blood pressure reduction of ≥ 10 mmHg during head-up tilt testing, with an area under the curve of 0.938, sensitivity of 100.0%, and specificity of 88.6% [19]. In the sit-up test, participants are passively moved from the supine to the sitting position with the assessor’s assistance. This enables the assessment of three types of impaired blood pressure regulation: OH, supine hypertension, and seated hypertension.

Previous studies have examined hemodynamic responses to the sit-up test in older adults [20, 21]; however, to the best of our knowledge, no studies have compared blood pressure responses between those with and without OH during this test. Additionally, no studies have investigated the associations between OH detected by the sit-up test and adverse health outcomes, such as physical frailty and advanced glycation end products (AGEs), in this population, particularly whether these associations persist independent of supine and seated hypertension status. Understanding these factors may highlight the potential role of the sit-up test in the early identification of health deterioration in older adults. Therefore, the primary objective of this study was to compare blood pressure responses during the sit-up test between community-dwelling older adults with and without OH, as defined by this test. We hypothesized that participants with OH would demonstrate higher supine systolic and diastolic blood pressure than those without OH, considering that individuals with OH frequently have supine hypertension [13–15]. Our secondary objective was to determine the associations between OH detected by the sit-up test and adverse health outcomes in these individuals, while adjusting for supine and seated hypertension status. We hypothesized that OH would be associated with adverse health outcomes, independent of seated hypertension.

Methods

Study design

This study used a cross-sectional design based on two considerations. First, our primary objective was to compare blood pressure responses during the sit-up test between older adults with and without OH at a specific time point, which aligns with the strengths of the cross-sectional design. Second, from ethical and scientific perspectives, we considered it essential to examine the association between OH detected by the sit-up test and adverse health outcomes before conducting longitudinal studies aimed at investigating causal relationships. We acknowledge the inherent limitations of the cross-sectional design, particularly its inability to establish causality. Accordingly, we interpreted our findings strictly as associations rather than causal relationships. The study protocol was approved by the appropriate ethics committee of Shinshu University (approval number: 6281). All participants provided written informed consent before enrolment. We followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines [22]. The study was performed in accordance with the 1964 Declaration of Helsinki, as revised in 2013.

We used Claude 3.5 Sonnet (Anthropic, San Francisco, CA, USA) to generate preliminary drafts and assist with English editing during the preparation of this work. We reviewed and edited the content after using this tool, and we assume full responsibility for the content of this publication.

Participants

Participants were recruited from attendees of community-based health promotion classes held in Shiga ward of Matsumoto City, Nagano, Japan. These classes, organized by the Community Development Division of Matsumoto City, were conducted at 27 different community centers between April 2023 and February 2024. Flyers with information on the classes were distributed to all households in Shiga ward to publicize the study. Residents voluntarily participated in the classes. The inclusion criteria were (1) age ≥ 65 years and (2) ability to walk independently, with or without assistive devices. Individuals were excluded if they had cognitive impairment or hearing loss preventing them from following the researcher’s instructions or if they declined to participate in the sit-up test.

Assessments of demographic and clinical outcomes

The self-reported questionnaire included age, sex, height, and weight as demographic outcomes. A body mass index of < 18.5 kg/m² was defined as being underweight, whereas that of ≥ 25.0 kg/m² was defined as having obesity [23].

Additionally, the questionnaire included information on clinical outcomes, such as the number of prescribed medications, history of falls within a year, and comorbidities. Polypharmacy was defined as having ≥ 5 regular medications prescribed, excluding supplements [24]. A fall was described as an event that results in a person unintentionally coming to rest on the ground or other lower-level surfaces [25]. Comorbidities included articular diseases, cancer, cardiac diseases, diabetes mellitus, respiratory diseases, and stroke. These diseases were listed in the survey, and the participants selected all that applied to them.

Assessment of geriatric outcomes

We assessed physical frailty and AGEs as geriatric outcomes. These outcomes have been associated with increased risks of adverse health outcomes, such as mortality and cardiovascular diseases [26–29]. Physical frailty is defined as a clinical syndrome of increased vulnerability due to diminished strength, endurance, and physiological function, resulting in increased dependency [30]. We assessed physical frailty using the revised Japanese version of the Cardiovascular Health Study criteria, which consists of five components: shrinking, exhaustion, low activity, slow gait speed, and weak handgrip strength [31]. Shrinking was defined as answering “yes” to the question “Have you unintentionally lost 2.0 kg or more in the past 6 months?” Exhaustion was defined as answering “yes” to “In the past 2 weeks, have you felt tired without a reason?” Low activity was defined by answering “no” to two questions: “Do you engage in moderate levels of physical exercise or sports aimed at health?” and “Do you engage in low levels of physical exercise aimed at health?” We measured the time required to walk 5 m at a comfortable speed [32]. Slow gait speed was defined as a comfortable gait speed of < 1.0 m/s. Handgrip strength was measured twice in the dominant hand with the participant squeezing a Smedley-type hand grip dynamometer (T.K.K. 5401; SANKA Co., Ltd., Niigata, Japan) as hard as possible. The greater value of the two measurements was analyzed [32]. Handgrip strength < 28.0 kg for male participants and < 18.0 kg for female participants was considered weak. Participants were classified as frail (≥ 3), pre-frail (1–2), or robust (none) based on the total number of positive items. The pre-frail and frail groups were combined into a non-robust group.

AGEs are a group of molecules generated nonenzymatically by sugars binding to proteins, lipids, or nucleic acids, resulting in protein modification and cross-linking [33]. AGE accumulation in tissues has been associated with age-related diseases, including diabetes, cardiovascular diseases, dementia, frailty, and sarcopenia [34–37]. AGEs can be non-invasively measured in the skin using skin autofluorescence [38]. Skin autofluorescence was measured from inside the forearm using a noninvasive device (AGE Reader mu; DiagnOptics Technologies, Groningen, the Netherlands), which has been validated as a reliable and valid instrument [38]. Skin autofluorescence was quantified as the ratio of average autofluorescence per nanometer (nm) within the 420–600 nm range to the average autofluorescence per nm within the 300–420 nm range, measured over a 1 cm² skin area. Skin autofluorescence values were expressed in arbitrary units. We ensured that the studied site lacked scars, and no cream was applied. Participants performed the measurements in the sitting position, with the volar side of the forearm placed on top of the AGE reader. The mean of three consecutive measurements was used to avoid erroneous measurements.

Sit-up test

The sit-up test was performed between 2:00 and 4:00 p.m. and more than 2 h after meals to avoid possible interference with postprandial hypotension [39]. The test comprised 5 min of rest in the supine position, followed by 3 min of rest in the sitting position. Specifically, after resting in the supine position, participants were passively moved (approximately 3 s) to the sitting position and maintained in that position for 3 min with the assistance of an assessor [17, 19]. Moreover, the participants were instructed not to assist with the maneuver during the test. The test was immediately terminated if a participant demonstrated severe symptoms such as presyncope, and the participant was returned to a supine position. Self-reported symptoms associated with OH, such as dizziness, lightheadedness, or blurred vision, were recorded at the end of the test.

Blood pressure was measured on the left arm using an automated sphygmomanometer (HEM-907; Omron Co., Ltd., Kyoto, Japan), which was calibrated according to the manufacturer’s guidelines before data collection. Systolic and diastolic blood pressures were measured in the supine position twice within 1 min after 5 min of rest. The mean of these two measurements was considered the supine blood pressure at baseline. During the sitting period, blood pressure variables were measured every minute. OH was defined as a maximum reduction of ≥ 10 mmHg in systolic blood pressure or ≥ 5 mmHg in diastolic blood pressure during the test. These cutoff points are based on a previous small-scale study that demonstrated high diagnostic accuracy in identifying stroke survivors who meet the conventional OH criteria (a decrease of ≥ 20 mmHg in systolic blood pressure or ≥ 10 mmHg in diastolic blood pressure) during head-up tilt testing [19]. Supine hypertension was defined as a systolic blood pressure of ≥ 140 mmHg or diastolic blood pressure of ≥ 90 mmHg in the supine position [13]. Seated hypertension was defined as a systolic blood pressure of ≥ 140 mmHg or diastolic blood pressure of ≥ 90 mmHg at 3 min of sitting [1].

Statistical analysis

The G power computer program version 3.1.9.2 (Heinrich Heine University, Dusseldorf, Germany) [40] was used for sample size calculation to detect blood pressure variable differences during the sit-up test between participants with and without OH. We used an estimated effect size of 0.80 for the unpaired t-test, based on a study comparing blood pressure variables in supine and sitting positions between older adults with and without OH [41]. The sample size was estimated to be 80, considering a statistical power of 0.80, an alpha level of 0.05, an expected prevalence of 22.2%, and an effect size of 0.80.

The normality of distribution for all continuous variables was assessed using the Shapiro–Wilk test. Blood pressure variables during the sit-up test were compared between the groups with and without OH using two-way repeated-measures analysis of variance (ANOVA), with the group as the between-subject factor and time (supine and 1–3 min of sitting) as the within-subject factor. An unpaired t-test with Bonferroni correction was used to compare blood pressure variables between the groups at each time point. Additionally, we compared the prevalence of supine and seated hypertension between participants with and without OH and that of seated hypertension between participants with and without supine hypertension using Fisher’s exact test.

To examine the associations between the three types of impaired blood pressure regulation detected by the sit-up test and adverse health outcomes, we compared participant characteristics between those with and without OH, supine hypertension, and seated hypertension. The unpaired t-test was used for continuous variables, and Fisher’s exact test was used for categorical variables. Participant characteristics included demographic, clinical, and geriatric outcomes. For participant characteristics that differed significantly between those with and without OH, we conducted a subgroup analysis comparing participants with isolated OH to those with OH co-existing with supine and/or seated hypertension. Fisher’s exact test was used for categorical variables, and one-way ANOVA was used for continuous variables.

Subsequently, we performed two sets of multivariate analyses to examine the independent associations of OH, supine hypertension, and seated hypertension with each participant’s characteristic variable. For the primary analysis (Model A), the presence of OH, supine hypertension, and seated hypertension served as independent variables, with no other covariates included. For the supplementary analysis (Model B), we constructed a fully adjusted model by adding potential confounders, such as age, sex, body mass index, and polypharmacy, to Model A. In these multivariate analyses, participants with missing values were excluded listwise. Multiple regression analyses were conducted with continuous dependent variables, whereas logistic regression analyses were performed with categorical dependent variables. Statistical analyses were performed using GraphPad Prism version 9.00 for Windows (GraphPad Software, San Diego, California, USA). Statistical significance was set at two-sided p < 0.050.

Results

Participants

The sit-up tests were conducted in 16 of the 24 classes owing to scheduling constraints, with 139 individuals attending these sessions. Of these, 114 underwent the sit-up test. In addition, 12 individuals were excluded from the analysis because they were below 65 years of age, resulting in a final sample of 102 participants. Table 1 lists the participant characteristics. Individual data on demographic, clinical, and geriatric outcomes, as well as blood pressure variables measured during the sit-up test, are available in Supplementary Table 1 (Additional File 1). Of all participants, 12 (11.8%) had at least one missing value for clinical and geriatric outcomes (Supplementary Table 2 in Additional File 2). The final sample had a mean age of 75.0 ± 6.0 years, with 67 females (65.7%). Additionally, 36 participants (35.3%) had at least one comorbidity, and 57 (56.4%) were classified as non-robust. Among those classified as non-robust, 50 were pre-frail.

Table 1.

Comparisons of demographic, clinical, and geriatric outcomes between participants with and without orthostatic hypotension

Variable	Overall (n = 102)	Orthostatic hypotension
Variable	Overall (n = 102)	Positive (n = 34)	Negative (n = 68)	p-value
Demographic outcomes
Age, years	75.0 ± 6.0	75.6 ± 6.8	74.6 ± 7.0	0.495
Age of 65 to 74 years	58 (56.9)	18 (52.9)	40 (58.8)	0.672
Female	67 (65.7)	18 (52.9)	49 (72.1)	0.077
Height, m	1.57 ± 0.10	1.60 ± 0.10	1.55 ± 0.09	0.020
Weight, kg	56.2 ± 10.4	57.7 ± 9.7	55.5 ± 10.7	0.300
Body mass index, kg/m²	22.7 ± 3.4	22.5 ± 3.0	22.9 ± 3.5	0.604
Body mass index of < 18.5 kg/m²	8 (7.8)	2 (5.9)	6 (8.8)	0.716
Body mass index of ≥ 25.0 kg/m²	27 (26.5)	8 (23.5)	19 (27.9)	0.812
Clinical outcomes
Polypharmacy (n_missing = 8)	24 (25.5)	10 (32.3)	14 (22.2)	0.322
Falls (n_missing = 1)	20 (19.8)	10 (30.3)	10 (14.7)	0.108
At least one comorbidity	36 (35.3)	20 (58.8)	16 (23.5)	< 0.001
Articular diseases	12 (11.8)	8 (23.5)	4 (5.9)	0.019
Cancer	1 (1.0)	1 (2.9)	0 (0.0)	0.333
Cardiac diseases	13 (12.7)	5 (14.7)	8 (11.8)	0.756
Diabetes mellitus	9 (8.8)	4 (11.8)	5 (7.4)	0.477
Respiratory diseases	5 (4.9)	4 (11.8)	1 (1.5)	0.041
Stroke	3 (2.9)	3 (8.8)	0 (0.0)	0.035
Geriatric outcomes
Non-robust (n_missing = 1)	57 (56.4)	25 (73.5)	32 (47.8)	0.019
Shrinking (n_missing = 1)	12 (11.9)	8 (24.2)	4 (5.9)	0.017
Exhaustion (n_missing = 2)	24 (24.0)	8 (25.0)	16 (23.5)	0.999
Low activity	25 (24.5)	11 (32.4)	14 (20.6)	0.226
Slow gait speed (n_missing = 1)	16 (15.8)	7 (21.2)	9 (13.2)	0.391
Gait speed, m/s (n_missing = 1)	1.30 ± 0.34	1.23 ± 0.30	1.34 ± 0.35	0.157
Weak handgrip strength (n_missing = 1)	14 (13.9)	8 (23.5)	6 (9.0)	0.066
Handgrip strength, kg (n_missing = 1)	26.3 ± 7.8	27.0 ± 8.7	25.9 ± 7.3	0.500
Skin autofluorescence, AU (n_missing = 1)	2.30 ± 0.40	2.43 ± 0.39	2.24 ± 0.39	0.024

Open in a new tab

Values are presented as mean ± standard deviation or number (%). (n_missing =) indicates the number of missing data

AU Arbitrary units

P-values marked in bold indicate significance

Comparisons of blood pressure variables during the sit-up test between participants with and without OH

Although all participants were asymptomatic during the sit-up test, 34 participants (33.3%) met either the systolic or diastolic blood pressure criteria for OH. Specifically, 26 showed systolic OH, whereas two exhibited diastolic OH. Six participants with OH met the systolic and diastolic criteria for OH.

Figure 1 shows blood pressure variables during the sit-up test in participants with and without OH. Two-way repeated-measures ANOVA revealed significant interactions between group and time for systolic (F_(3,297) = 47.0, p < 0.001; Fig. 1A) and diastolic (F_(3,297) = 26.5, p < 0.001; Fig. 1B) blood pressure, indicating that participants with OH showed a greater decrease in systolic blood pressure and a smaller increase in diastolic blood pressure during the test than those without OH. Participants with OH showed significantly higher mean systolic blood pressure values in the supine position than those without OH (t = 3.363, p = 0.005, Bonferroni multiple comparison test), whereas no significant differences were observed between the groups at any time point during the sitting period (Fig. 1A). Participants with OH demonstrated significantly lower mean values of diastolic blood pressure at 2 min of sitting than those without OH (t = 2.733, p = 0.032, Bonferroni multiple comparison test), whereas no significant differences were observed between the groups at other time points (Fig. 1B). Furthermore, the results stratified by age (Supplementary Figs. 1 and 2) and sex (Supplementary Figs. 3 and 4) are shown in Additional File 3. Age was categorized as 65 to 74 years and 75 years or older [42]. Regardless of age and sex, there were significant interactions between group and time for systolic and diastolic blood pressure, indicating that a greater systolic blood pressure decrease and a smaller diastolic blood pressure increase were observed in participants with OH than in those without.

Fig. 1 — Blood pressure variables during the sit-up test in participants with and without orthostatic hypotension. (A) Systolic and (B) diastolic blood pressure changes during the sit-up test. The white and blue diamonds represent the mean blood pressure values in the groups with and without orthostatic hypotension, respectively, at each time point. The error bars indicate 95% confidence intervals. The x-axis represents time in minutes. Data at x = 0 corresponds to the mean of two baseline blood pressure measurements taken in the supine position after 5 min of rest. Data at x = 1, 2, and 3 correspond to measurements taken at the first, second, and third minute, respectively, after participants were passively moved to the sitting position. The asterisks indicate significant differences between the groups with and without orthostatic hypotension (p < 0.05, Bonferroni multiple comparison test).

Overall, 36 participants (35.3%) had supine hypertension and 33 (32.4%) had seated hypertension. Supplementary Table 3 in Additional File 4 describes the impaired blood pressure regulation status of the participants. Of the 34 participants with OH, nine had supine and seated hypertension, nine had supine hypertension alone, and 16 had isolated OH. A significantly higher proportion of participants with OH (52.9%, n = 18) had supine hypertension compared to those without OH (26.5%, n = 18, p = 0.015). However, no significant difference was observed in the proportion of participants with seated hypertension between those with OH (26.5%, n = 9) and those without OH (35.3%, n = 24, p = 0.501). Additionally, a significantly larger proportion of participants with supine hypertension (63.9%, n = 23) had seated hypertension compared to those without supine hypertension (15.2%, n = 10, p < 0.001).

Comparisons of participant characteristics between those with and without OH

Table 1 shows the results of the comparative analysis. Regarding demographic outcomes, the mean height values were significantly higher in participants with OH than in those without (t = 2.356, p = 0.020). The remaining demographic outcomes did not differ significantly between the groups (p > 0.050).

Regarding clinical outcomes, a greater proportion of participants with OH (58.8%, n = 20) self-reported at least one comorbidity compared to those without OH (23.5%, n = 16, p < 0.001). Specifically, participants with OH demonstrated a higher prevalence of articular diseases (23.5%, n = 8 vs. 5.9%, n = 4, p = 0.019), respiratory diseases (11.8%, n = 4 vs. 1.5%, n = 1, p = 0.041), and stroke (8.8%, n = 3 vs. 0.0%, n = 0, p = 0.035) than participants without OH.

Regarding geriatric outcomes, a greater proportion of participants with OH (73.5%, n = 25) were classified as non-robust compared to those without OH (47.8%, n = 32, p = 0.019). The prevalence of shrinking was significantly higher in participants with OH (24.2%, n = 8) than in those without (5.9%, n = 4, p = 0.017). Furthermore, the mean skin autofluorescence values were significantly higher in participants with OH than in those without (t = 2.300, p = 0.024).

Supplementary Table 4 in Additional File 5 shows the results of subgroup analysis in participants with OH. No significant differences were observed in any of the variables among participants with isolated OH, those with OH and supine hypertension, and those with all three types of impaired blood pressure regulation (p > 0.050).

Comparisons of participant characteristics according to supine and seated hypertension status

Table 2 illustrates the results of comparisons of participant characteristics according to supine and seated hypertension status. Participants with supine hypertension were significantly older than those without (t = 2.508, p = 0.014). Additionally, a larger proportion of participants with supine hypertension (40.6%, n = 13) self-reported polypharmacy compared to those without supine hypertension (17.7%, n = 11, p = 0.024). However, no participant characteristics showed a significant difference between those with and without seated hypertension (p > 0.050).

Table 2.

Comparisons of demographic, clinical, and geriatric outcomes according to supine and seated hypertension status

Variable	Supine hypertension			Seated hypertension
Variable	Positive (n = 36)	Negative (n = 66)	p-value	Positive (n = 33)	Negative (n = 69)	p-value
Demographic outcomes
Age, years	77.2 ± 6.2	73.7 ± 7.0	0.014	75.6 ± 5.0	74.6 ± 7.7	0.492
Age of 65 to 74 years	15 (41.7)	43 (65.2)	0.038	16 (48.5)	42 (60.9)	0.287
Female	23 (63.9)	44 (66.7)	0.829	25 (75.8)	42 (60.9)	0.182
Height, m	1.58 ± 0.09	1.57 ± 0.10	0.567	1.56 ± 0.09	1.58 ± 0.10	0.433
Weight, kg	57.6 ± 9.8	55.5 ± 10.7	0.324	56.1 ± 10.1	56.3 ± 10.6	0.931
Body mass index, kg/m²	23.1 ± 3.6	22.5 ± 3.3	0.376	23.0 ± 3.4	22.6 ± 3.3	0.590
Body mass index of < 18.5 kg/m²	2 (5.6)	6 (9.1)	0.709	1 (3.0)	7 (10.1)	0.432
Body mass index of ≥ 25.0 kg/m²	13 (36.1)	14 (21.2)	0.158	10 (30.3)	17 (24.6)	0.633
Clinical outcomes
Polypharmacy (n_missing = 8)	13 (40.6)	11 (17.7)	0.024	11 (35.5)	13 (20.6)	0.137
Falls (n_missing = 1)	10 (28.6)	10 (15.2)	0.122	7 (21.2)	13 (19.1)	0.796
At least one comorbidity	16 (44.4)	20 (30.3)	0.194	12 (36.4)	24 (34.8)	0.999
Articular diseases	5 (13.9)	7 (10.6)	0.750	4 (12.1)	8 (11.6)	0.999
Cancer	1 (2.8)	0 (0.0)	0.353	0 (0.0)	1 (1.4)	0.999
Cardiac diseases	7 (19.4)	6 (9.1)	0.212	7 (21.2)	6 (8.7)	0.111
Diabetes mellitus	3 (8.3)	6 (9.1)	0.999	2 (6.1)	7 (10.1)	0.714
Respiratory diseases	3 (8.3)	2 (3.0)	0.342	1 (3.0)	4 (5.8)	0.999
Stroke	1 (2.8)	2 (3.0)	0.999	0 (0.0)	3 (4.3)	0.549
Geriatric outcomes
Non-robust (n_missing = 1)	23 (65.7)	34 (51.5)	0.208	20 (62.5)	37 (53.6)	0.518
Shrinking (n_missing = 1)	5 (14.3)	7 (10.6)	0.748	2 (6.1)	10 (14.7)	0.328
Exhaustion (n_missing = 2)	11 (32.4)	13 (19.7)	0.217	10 (30.3)	14 (20.9)	0.327
Low activity	8 (22.2)	17 (25.8)	0.811	6 (18.2)	19 (27.5)	0.338
Slow gait speed (n_missing = 1)	7 (19.4)	9 (13.6)	0.570	4 (12.1)	12 (17.4)	0.573
Gait speed, m/s (n_missing = 1)	1.36 ± 0.40	1.27 ± 0.29	0.187	1.38 ± 0.40	1.27 ± 0.30	0.123
Weak handgrip strength (n_missing = 1)	5 (14.3)	9 (13.6)	0.999	4 (12.5)	10 (14.5)	0.999
Handgrip strength, kg (n_missing = 1)	26.9 ± 8.4	25.9 ± 7.5	0.535	25.4 ± 8.0	26.7 ± 7.7	0.440
Skin autofluorescence, AU (n_missing = 1)	2.36 ± 0.44	2.27 ± 0.38	0.285	2.25 ± 0.39	2.33 ± 0.40	0.359

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Values are presented as mean ± standard deviation or number (%). (n_missing =) indicates the number of missing data

AU Arbitrary units

P-values marked in bold indicate significance

Independent associations of OH, supine hypertension, and seated hypertension with participant characteristics

Table 3 shows the results of the multiple and logistic regression analyses for Model A. In this model, OH was significantly associated with greater height [partial regression coefficient = 0.04, 95% confidence interval (CI) = 0.00–0.08, p = 0.048], higher prevalences of at least one comorbidity (odds ratio = 4.50, 95%CI = 1.74–11.6, p = 0.002) and articular diseases (odds ratio = 5.68, 95%CI = 1.40–23.10, p = 0.015), and a higher proportion of non-robust participants (odds ratio = 3.08, 95%CI = 1.17–8.08, p = 0.022) and those with shrinking (odds ratio = 4.32, 95%CI = 1.11–16.80, p = 0.032), even when controlling for supine and seated hypertension status. The results stratified by age (Supplementary Tables 5 and 6) or sex (Supplementary Tables 7 and 8) are shown in Additional File 6. A significant independent association between OH and a higher prevalence of at least one comorbidity was found in those aged 65 to 74 years (odds ratio = 11.30, 95%CI = 2.58–49.10, p = 0.001) and male participants (odds ratio = 12.40, 95%CI = 2.05–74.90, p = 0.006). Additionally, there was a significant independent association between OH and a higher prevalence of non-robust status in those aged 75 years or older (odds ratio = 7.25, 95%CI = 1.21–43.30, p = 0.023) and female participants (odds ratio = 6.10, 95%CI = 1.15–32.40, p = 0.034). In Model B (Supplementary Table 9 in Additional File 7), OH remained significantly associated with a higher prevalence of at least one comorbidity (odds ratio = 5.10, 95%CI = 1.82–14.30, p = 0.002) and articular diseases (odds ratio = 7.04, 95%CI = 1.54–32.30, p = 0.012). Although the association with a non-robust status was attenuated (odds ratio = 2.84, 95%CI = 0.93–8.69, p = 0.068), OH showed significant associations with shrinking (odds ratio = 4.58, 95%CI = 1.10–19.00, p = 0.036) and weak handgrip strength (odds ratio = 7.46, 95%CI = 1.26–44.00, p = 0.027).

Table 3.

Independent associations of three types of impaired blood pressure regulation with demographic, clinical, and geriatric outcomes (Model A)

Variable	Orthostatic hypotension		Supine hypertension		Seated hypertension
Variable	Coefficient (95%CI)	p-value	Coefficient (95%CI)	p-value	Coefficient (95%CI)	p-value
Demographic outcomes
Age^*	B = −0.18 (−3.22, 2.87)	0.909	B = 4.08 (0.63, 7.53)	0.021	B = −1.08 (−4.49, 2.34)	0.533
Age of 65 to 74 years	OR = 1.01 (0.41, 2.52)	0.983	OR = 0.39 (0.14, 1.08)	0.069	OR = 0.98 (0.35, 2.72)	0.966
Female	OR = 0.50 (0.20, 1.26)	0.144	OR = 0.71 (0.24, 2.13)	0.538	OR = 2.31 (0.74, 7.21)	0.149
Height^*	B = 0.04 (0.00, 0.08)	0.048	B = 0.01 (−0.04, 0.06)	0.726	B = −0.02 (−0.06, 0.03)	0.492
Weight^*	B = 1.54 (−3.13, 6.20)	0.514	B = 2.34 (−2.95, 7.62)	0.382	B = −1.24 (−6.48, 3.99)	0.638
Body mass index^*	B = −0.59 (−2.11, 0.93)	0.442	B = 0.81 (−0.91, 2.53)	0.352	B = −0.06 (−2.11, 0.93)	0.927
Body mass index of < 18.5 kg/m²	OR = 0.55 (0.09, 3.24)	0.510	OR = 1.24 (0.18, 8.66)	0.826	OR = 0.24 (0.02, 2.56)	0.235
Body mass index of ≥ 25.0 kg/m²	OR = 0.58 (0.20, 1.65)	0.305	OR = 2.80 (0.90, 8.73)	0.076	OR = 0.75 (0.24, 2.32)	0.618
Clinical outcomes
Polypharmacy	OR = 1.40 (0.50, 3.93)	0.528	OR = 2.59 (0.78, 8.61)	0.119	OR = 1.28 (0.39, 4.26)	0.684
Falls	OR = 2.08 (0.71, 6.07)	0.179	OR = 2.09 (0.60, 7.32)	0.249	OR = 0.82 (0.23, 2.95)	0.757
At least one comorbidity	OR = 4.50 (1.74, 11.60)	0.002	OR = 1.21 (0.40, 3.61)	0.737	OR = 1.15 (0.38, 3.48)	0.810
Articular diseases	OR = 5.68 (1.40, 23.10)	0.015	OR = 0.69 (0.14, 3.44)	0.651	OR = 1.55 (0.30, 7.92)	0.598
Cancer	NA	NA	NA	NA	NA	NA
Cardiac diseases	OR = 1.28 (0.34, 4.81)	0.720	OR = 1.48 (0.34, 6.45)	0.605	OR = 2.38 (0.57, 9.98)	0.236
Diabetes mellitus	OR = 1.61 (0.36, 7.14)	0.531	OR = 1.01 (0.17, 5.88)	0.992	OR = 0.59 (0.09, 3.98)	0.591
Respiratory diseases	OR = 6.26 (0.61, 64.80)	0.124	OR = 2.85 (0.34, 24.1)	0.336	OR = 0.34 (0.03, 4.22)	0.403
Stroke	NA	NA	NA	NA	NA	NA
Geriatric outcomes
Non-robust	OR = 3.08 (1.17, 8.08)	0.022	OR = 1.12 (0.39, 3.21)	0.826	OR = 1.53 (0.54, 4.32)	0.426
Shrinking	OR = 4.32 (1.11, 16.80)	0.035	OR = 1.63 (0.35, 7.59)	0.534	OR = 0.31 (0.05, 1.97)	0.212
Exhaustion	OR = 0.95 (0.33, 2.71)	0.927	OR = 1.79 (0.55, 5.80)	0.331	OR = 1.20 (0.38, 3.82)	0.756
Low activity	OR = 1.89 (0.69, 5.16)	0.216	OR = 0.83 (0.25, 2.73)	0.755	OR = 0.68 (0.20, 2.30)	0.535
Slow gait speed	OR = 1.37 (0.43, 4.41)	0.597	OR = 2.20 (0.57, 8.52)	0.252	OR = 0.43 (0.10, 1.84)	0.252
Gait speed^*	B = −0.12 (−0.27, 0.03)	0.109	B = 0.10 (−0.07, 0.27)	0.259	B = 0.05 (−0.12, 0.22)	0.560
Weak handgrip strength	OR = 3.51 (1.00, 12.30)	0.051	OR = 0.69 (0.15, 3.08)	0.625	OR = 1.14 (0.25, 5.20)	0.864
Handgrip strength^*	B = 0.39 (−3.14, 3.92)	0.827	B = 1.99 (−2.01, 5.99)	0.326	B = −2.26 (−6.21, 1.69)	0.259
Skin autofluorescence^*	B = 0.15 (−0.03, 0.33)	0.093	B = 0.11 (−0.09, 0.31)	0.279	B = −0.12 (−0.32, 0.08)	0.233

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The asterisks in the variable column indicate that multiple regression analysis was employed as a multivariate analysis owing to the continuous nature of the dependent variable. Participants with missing values were excluded listwise

B Partial regression coefficient, CI Confidence interval, NA Not applicable, OR Odds ratio

P-values marked in bold indicate significance

Supine hypertension was significantly associated with older age in Model A (partial regression coefficient = 4.08, 95%CI = 0.63–7.53, p = 0.021) and Model B (partial regression coefficient = 4.20, 95%CI = 0.61–7.79, p = 0.022). No significant associations were observed between seated hypertension and participant characteristics (p > 0.050) in Model A, although a significant independent association was observed between seated hypertension and female sex in Model B (odds ratio = 3.74, 95%CI = 1.00–14.00, p = 0.049).

Discussion

To the best of our knowledge, this study is the first to investigate the associations of OH detected by the sit-up test with blood pressure variables during the test and adverse health outcomes in community-dwelling older adults. Participants with OH demonstrated a greater decrease in systolic blood pressure, a smaller increase in diastolic blood pressure, and higher supine systolic blood pressure during the sit-up test compared to those without OH. Consequently, more than 50% of participants with OH showed supine hypertension. Moreover, OH showed independent associations with adverse health outcomes, regardless of supine and seated hypertension status. Our findings provide valuable insights for the application of the sit-up test in preventive health screenings for older adults.

Differences in blood pressure variables during the sit-up test between participants with and without OH

The prevalence of OH in our study (33.3%) was higher than that reported in previous studies using conventional standing tests (22.2%) [12]. These conventional methods include the head-up tilt and active standing tests. The discrepancy in prevalence rates between the studies may be attributed to our methodological approach for diagnosing OH. Consensus guidelines recommend that a reduction in systolic blood pressure of 30 mmHg, rather than the standard 20 mmHg, during conventional standing tests is a more appropriate diagnostic criterion for OH in individuals with supine hypertension [4]. However, such diagnostic thresholds have not been established for the sit-up test. Therefore, we applied the same criteria regardless of supine hypertension status, which likely contributed to the higher prevalence of OH in this study than in previous studies [12].

Participants with OH demonstrated significantly higher supine systolic blood pressure than those without OH, in line with previous studies [41, 43–45], resulting in a higher prevalence of supine hypertension. This relationship may be explained by several physiological mechanisms, such as age-related physiological impairments in baroreflex sensitivity and autonomic cardiovascular regulation [2, 13, 46]. Conversely, the prevalence of seated hypertension did not differ significantly between those with and without OH. This result may be attributed to two distinct blood pressure responses to the sit-up test. First, participants with OH exhibited a greater reduction in systolic blood pressure during the test, resulting in no significant difference in seated systolic blood pressure between those with and without OH. Second, those with OH demonstrated a blunted increase in diastolic blood pressure during the test, despite no significant difference in supine diastolic blood pressure between participants with and without OH. Diastolic blood pressure typically increases by 5–10 mmHg upon standing owing to peripheral vasoconstriction and stroke volume reduction [47]. Therefore, the blunted increase in diastolic blood pressure during the sit-up test likely reflects impaired arterial baroreflex-mediated function, which is considered the primary hemodynamic mechanism underlying OH in older adults [44, 48].

Associations of OH detected by the sit-up test with adverse health outcomes

Our findings revealed that OH was significantly associated with higher proportions of participants with at least one comorbidity and those classified as non-robust, even after adjusting for supine and seated hypertension. The results of subgroup and supplementary analyses with adjustments for potential confounders support the robustness of the associations between OH and adverse health conditions. Although the association with a non-robust status was attenuated, OH remained significantly associated with specific frailty components, including shrinking and weak handgrip strength, suggesting a persistent association with physical frailty. In contrast, seated hypertension showed no significant association with any of the demographic, clinical, and geriatric outcomes. These findings suggest that the sit-up test can provide more valuable information for blood pressure management in older adults than conventional seated blood pressure measurements.

Previous studies of older adults have documented associations of OH with age-related diseases and physical frailty [21, 49–54]. OH remains the most common measure of autonomic dysfunction [55]. Autonomic dysfunction is associated with various age-related disorders, such as articular diseases, cardiac diseases, cancer, diabetes, respiratory diseases, and stroke [56–61]. Furthermore, older adults with physical frailty are more likely to have autonomic dysfunction [55]. Therefore, autonomic dysfunction may underlie the observed associations between OH and adverse health outcomes.

The observed association between OH and non-robust status may support the longitudinal associations of OH with mortality and morbidity reported in previous studies [4–11], considering the association between physical frailty and an increased risk of future adverse health outcomes [26, 27]. Additional longitudinal studies are required to determine whether OH detected by the sit-up test has stronger associations with future adverse events than supine and seated hypertension.

Clinical implications

Many individuals with OH are asymptomatic or only mildly symptomatic, which is potentially attributed to habituation and cerebral autoregulation [62]. Here, all participants with OH were asymptomatic, highlighting how this condition can remain undetected without objective assessment. These findings emphasize the importance of measuring postural blood pressure changes to identify OH in community-dwelling older adults.

The sit-up test provides several clinical advantages in assessing OH in the geriatric population. First, it is safer than the active standing test commonly used in primary care, as patients remain on the examination bed throughout the test, eliminating the risk of falls during the assessment. This characteristic makes it particularly valuable for older adults with a history of falls, balance impairments, or mobility limitations. Second, unlike the head-up tilt test, which requires a tilt table, the test can be performed at the bedside. This enhances its utility across various clinical settings, including community-based health checkups, home-visit medical care, and long-term care facilities. Third, it requires minimal training–basic blood pressure measurement skills and the ability to assist with sitting up. Fourth, the entire assessment takes less than 10 min, making it feasible for routine screening. The recommended protocol is as follows: 1) introduce the procedure and obtain consent; 2) position the individual supine and allow 5 min of rest; 3) measure baseline blood pressure twice; 4) passively assist the individual to a sitting position in approximately 3 s; 5) measure blood pressure every minute for 3 min; 6) document any symptoms reported; and 7) if severe symptoms are reported, return the individual to a supine position immediately. A decrease of ≥ 10 mmHg in systolic or ≥ 5 mmHg in diastolic blood pressure indicates OH, warranting further clinical assessment, such as medication review.

Furthermore, given our findings suggesting that autonomic dysfunction underlies the associations between OH and adverse health outcomes, detecting asymptomatic OH using the sit-up test may identify individuals who could benefit from early therapeutic interventions to reduce the risk of future adverse events, such as cardiovascular diseases and falls. Future studies should investigate whether clinical management strategies guided by the sit-up test results improve adverse health outcomes in older adults.

Study limitations

This study has some limitations that warrant consideration. First, the cross-sectional design precludes establishing causality between impaired blood pressure regulation and adverse health outcomes. Consequently, we cannot determine whether OH leads to adverse health conditions or whether these conditions share common pathophysiological mechanisms. Longitudinal studies involving repeated measurements of OH and adverse health outcomes are required to clarify temporal relationships and potential causal pathways. Despite this limitation, our findings offer valuable preliminary evidence of relevant associations that merit further investigation through a prospective study design. Second, recruitment from community health promotion classes may have introduced a selection bias toward health-conscious individuals. Third, our study included only independently ambulatory older adults; thus, we excluded those who might have truly required the sit-up test. This potential selection bias may limit the generalizability of our findings to populations with poorer health and mobility. Future studies should include homebound older adults and residents of care facilities. Fourth, although the sit-up test appears to be a suitable alternative for identifying OH, its diagnostic accuracy may be lower than that of conventional standing tests. The cutoff points for detecting OH in the sit-up test were established based on comparisons with the head-up tilt test [19]. OH identified by the head-up tilt test has shown stronger associations with poor functional outcomes in older adults than that identified by the active standing test [63]. This evidence supports our choice to adopt the cutoff points derived from comparisons with the head-up tilt test for assessing OH via the sit-up test. However, the previous study reporting these cutoff points included only stroke survivors and had a relatively small sample size of 38 participants [19]. Thus, because the diagnostic thresholds of the test are based on limited prior research, its clinical role remains under investigation. Although the test appears promising, prospective validation with larger and more diverse samples is needed to refine its diagnostic criteria for OH. Moreover, future studies comparing the strength of associations between OH and adverse health outcomes across the sit-up and conventional standing tests are required to enhance the scientific validity and practical utility of our findings. Finally, clinical outcomes, including the number of prescribed medications, history of falls within a year, and comorbidities, were based on self-reported data, which may be subject to recall and reporting biases. Additionally, the demographic, clinical, and geriatric outcomes collected in this study were relatively limited. Further research should incorporate more detailed information on medication use, particularly antihypertensive agents, as well as more comprehensive assessments of functional status, including postural balance and daily physical activity. This would enhance the understanding of the differences in blood pressure responses to the sit-up test between older adults with and without OH and of the association between OH and adverse health outcomes in this population.

Conclusion

OH was associated with a greater decrease in systolic blood pressure, smaller increase in diastolic blood pressure, and higher supine systolic blood pressure during the sit-up test in community-dwelling older adults. Therefore, more than 50% of the participants with OH had supine hypertension. In addition, OH detected by the sit-up test was associated with adverse health outcomes independent of supine and seated hypertension. The application of the sit-up test in routine health screenings may identify community-dwelling older adults at a higher risk of experiencing health deterioration. However, the clinical role of the sit-up test is still under investigation. Prospective validation in more diverse cohorts is required to confirm its diagnostic thresholds and clinical utility before it can be recommended for widespread use.

Supplementary Information

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Supplementary Material 1: Supplementary Table 1. Individual data on demographic, clinical, and geriatric outcomes and blood pressure variables measured during the sit-up test.

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Supplementary Material 2: Supplementary Table 2. Summary of missing values in clinical and geriatric outcomes.

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Supplementary Material 3: Supplementary Figure 1. Blood pressure variability during the sit-up test in participants aged 65–74 years with and without orthostatic hypotension. Supplementary Figure 2. Blood pressure variability during the sit-up test in participants aged 75 years or older with and without orthostatic hypotension. Supplementary Figure 3. Blood pressure variability during the sit-up test in female participants with and without orthostatic hypotension. Supplementary Figure 4. Blood pressure variability during the sit-up test in male participants with and without orthostatic hypotension.

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Supplementary Material 4: Supplementary Table 3. Impaired blood pressure regulation status among participants.

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Supplementary Material 5: Supplementary Table 4. Subgroup analyses of participants with orthostatic hypotension.

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Supplementary Material 6: Supplementary Table 5. Independent associations of three types of impaired blood pressure regulation with demographic, clinical, and geriatric outcomes in participants aged 65 to 74 years. Supplementary Table 6. Independent associations of three types of impaired blood pressure regulation with demographic, clinical, and geriatric outcomes in participants aged 75 years or more. Supplementary Table 7. Independent associations of three types of impaired blood pressure regulation with demographic, clinical, and geriatric outcomes in female participants. Supplementary Table 8. Independent associations of three types of impaired blood pressure regulation with demographic, clinical, and geriatric outcomes in male participants.

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Supplementary Material 7: Supplementary Table 9. Independent associations of three types of impaired blood pressure regulation with demographic, clinical, and geriatric outcomes after adjustment for age, sex, body mass index, and polypharmacy (Model B).

Acknowledgements

We would like to thank the staff at Shiga Ward Community Development Center for their help and support. We also appreciate Editage (www.editage.com) for English language editing.

Abbreviations

AGEs: Advanced glycation end products
ANOVA: Analysis of variance
CI: Confidence interval
OH: Orthostatic hypotension

Authors’ contributions

Conceptualization: KO, YY; Data curation: KO, YY; Formal analysis: KO; Funding acquisition: KO; Investigation: KO, YY; Methodology: KO, YY; Project administration: YY; Resources: KO, YY; Software: KO; Supervision: YY; Validation: KO; Visualization: KO; Writing-original draft: KO; Writing-review and editing: KO, YY; Approval of final manuscript: KO, YY.

Funding

This work was supported by a grant from JSPS KAKENHI Grant Number JP21K17489 awarded to KO. The funding source had no involvement in the study design; collection, analysis and interpretation of data; writing of the report; and the decision to submit the article for publication.

Data availability

All data supporting the findings of this study are available within the paper and its Additional Files.

Declarations

Ethics approval and consent to participate

This study protocol was approved by the appropriate ethics committee of Shinshu University (approval number: 6281). All participants provided written informed consent before enrolment in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

12877_2025_6456_MOESM1_ESM.xlsx^{(30.7KB, xlsx)}

Supplementary Material 1: Supplementary Table 1. Individual data on demographic, clinical, and geriatric outcomes and blood pressure variables measured during the sit-up test.

12877_2025_6456_MOESM2_ESM.pdf^{(93.5KB, pdf)}

Supplementary Material 2: Supplementary Table 2. Summary of missing values in clinical and geriatric outcomes.

12877_2025_6456_MOESM3_ESM.pdf^{(342.2KB, pdf)}

12877_2025_6456_MOESM4_ESM.pdf^{(86.6KB, pdf)}

Supplementary Material 4: Supplementary Table 3. Impaired blood pressure regulation status among participants.

12877_2025_6456_MOESM5_ESM.pdf^{(105.5KB, pdf)}

Supplementary Material 5: Supplementary Table 4. Subgroup analyses of participants with orthostatic hypotension.

12877_2025_6456_MOESM6_ESM.pdf^{(399.4KB, pdf)}

12877_2025_6456_MOESM7_ESM.pdf^{(202KB, pdf)}

Data Availability Statement

All data supporting the findings of this study are available within the paper and its Additional Files.

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PERMALINK

Sit-up test for assessing impaired blood pressure regulation in community-dwelling older adults: a cross-sectional study

Kazuaki Oyake

Yoshiharu Yokokawa

Abstract

Background

Methods

Results

Conclusion

Supplementary Information

Background

Methods

Study design

Participants

Assessments of demographic and clinical outcomes

Assessment of geriatric outcomes

Sit-up test

Statistical analysis

Results

Participants

Table 1.

Comparisons of blood pressure variables during the sit-up test between participants with and without OH

Fig. 1.

Comparisons of participant characteristics between those with and without OH

Comparisons of participant characteristics according to supine and seated hypertension status

Table 2.

Independent associations of OH, supine hypertension, and seated hypertension with participant characteristics

Table 3.

Discussion

Differences in blood pressure variables during the sit-up test between participants with and without OH

Associations of OH detected by the sit-up test with adverse health outcomes

Clinical implications

Study limitations

Conclusion

Supplementary Information

Acknowledgements

Abbreviations

Authors’ contributions

Funding

Data availability

Declarations

Ethics approval and consent to participate

Consent for publication

Competing interests

Footnotes

References

Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

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