Orthostatic Hypotension among Vietnamese Older Adults with Type 2 Diabetes And Its Predictors

Objective: Orthostatic hypertension (OH) is one of the most common symptoms of autonomic nervous system disorder in patients with type 2 diabetes. This study aimed to determine the percentage of OH among Vietnamese older adults with type 2 diabetes and its influencing factors. Methods: A cross‐sectional descriptive study was conducted using convenience sampling to recruit 96 older adults with type 2 diabetes who received care at a large hospital in central Vietnam between November 2020 and June 2021. Data were collected using a demographic and health-related questionnaire and Omron electronic sphygmomanometers for blood pressure (BP) measurement. OH was diagnosed according to the 1996 diagnosis criteria of the American Autonomic Society and the American Academy of Neurology. Descriptive statistics, independent t-test, chi-square, and univariable and multivariable logistic regression were used for analysis, with p-value ≤ 0.05 considered significant. Results: The relative frequency of orthostatic hypotension (OH) among older adults with type 2 diabetes was 46.9%. Multivariable logistic regression identified gender, HbA1C level, and duration of diabetes as significant predictors of OH. Specifically, females had 5.44-fold higher odds of developing OH compared to males (OR = 5.44; 95% CI: 1.94–15.25; P = 0.001). Each one-unit increase in HbA1C was associated with a 1.33-fold increase in the odds of OH (OR = 1.33; 95% CI: 1.002-1.77; P = 0.049). Additionally, longer diabetes duration was linked to higher odds of OH, with an 8.3% increase in odds for each additional year of diabetes (OR = 1.08; 95% CI: 1.01–1.16; P = 0.018). Although stroke history and kidney failure showed elevated odds ratios, their associations with OH were not statistically significant (P > 0.05). Conclusion: Orthostatic hypotension (OH) is highly prevalent among older adults with type 2 diabetes, particularly in females with prolonged disease duration and poor glycemic control (high HbA1C). Clinically, these findings highlight the need for healthcare providers to prioritize routine screening and tailored management strategies for this high-risk group, aiming to prevent complications such as falls, cardiovascular events, and decreased quality of life.