Could the monocyte-to-high-density lipoprotein cholesterol ratio serve as a reliable marker for orthostatic hypotension in older adults: a cross-sectional study?

Background: Orthostatic Hypotension is a condition that increases in frequency with age and is associated with inflammation. This study investigates the relationship between the Monocyte-to-High-Density Lipoprotein Cholesterol Ratio (MHR) and OH in older adults. Methods: It was designed as a cross-sectional and observational study at our Geriatric outpatient clinic. Total of 229 patients were assessed retrospectively. OH was evaluated based on the active standing test. Logistic regression analysis was utilized to assess the association between MHR and both OH and supine hypertension (HT). Results: Of the 229 patients in the study, 73.5% were female, and the mean age was 76.75±6.52 years. The OH and control groups differed significantly in terms of sex, age, body mass index (BMI), malnutrition, frailty and probable sarcopenia. The MHRs were higher in both the OH group and the supine HT subgroup when compared to the control group (p<0.05). The cut-off value for MHR in the OH group was 9.28 (p=0.023). In a regression analysis, a significant relationship was observed between the presence of OH and MHR, independent of confounding factors (odds ratio (OR) 1.09;p=0.045). Similarly, an independent relationship was identified between the presence of supine HT and MHR (OR 1.1;p=0.033). Conclusions: MHR was found to be independently associated with OH in older adults, while supine HT within the OH group may be linked to MHR after adjusting for confounding factors.