Morbidity and mortality related to orthostatic hypotension: results of a meta-analysis of non-randomized observational studies

Ricci, Fabrizio; Radico, Francesco; Romanello, Mattia; Tatasciore, Alfonso; Nicola, Marta Di; Zimarino, Marco; Caterina, R De

doi:10.1093/eurheartj/eht310.4462

Cited by 3 publications

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“…The importance of age as a significant predictor of OH was also confirmed in our study. From this perspective, OH is a clinically relevant disorder, particularly for elderly patients who are more likely to fall, develop cardiovascular diseases or cancer [31] increasing as well significantly risk of mortality from any cause [32][33][34].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Orthostatic Hypotension in Cancer Patients

Iwański,

Sokołowska,

Sokołowski

et al. 2024

Preprint

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Background: Orthostatic hypotension (OH) is associated with higher risk of mortality in general population however not studied in cancer population. The study aimed to assess the prevalence of OH in cancer patients compared to the non-cancer population. Methods: A total of 411 patients (mean age 63.5 ± 10.6 years) were recruited: patients with active cancer (n = 223) and patients hospitalized for other reasons but without cancer diagnosis (n = 188). Medical history was collected and an orthostatic challenge test was performed. OH was defined as blood pressure (BP) decrease on standing ≥ 20 mmHg for systolic or ≥ 10 mmHg for diastolic BP in 1 or 3 minutes; or systolic BP decrease &lt; 90 mmHg. Results: The prevalence of OH in cancer was significantly higher than in subjects without cancer- 28.7% vs. 16.5%, respectively, P = 0.003). OH was the most common in lung cancer, 57.5%. In single variable analysis, the predictors of OH were: cancer presence, age ≥ 65 years, and body mass index (BMI) ≥ 30 kg/m2. In the multivariable model, the strongest independent predictor of OH was cancer status doubling the risk of OH; BMI ≥ 30 kg/m2 and diabetes. Conclusions: Cancer patients are characterized by a high prevalence of OH. In this population, the recommendation of routine orthostatic challenge tests should be considered.

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Section: Discussionmentioning

confidence: 99%

The Prevalence of Orthostatic Hypotension in Cancer Patients

Iwański,

Sokołowska,

Sokołowski

et al. 2024

Preprint

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“…The importance of age as a significant predictor of OH was also confirmed in our study. From this perspective, OH is a clinically relevant disorder, particularly for elderly patients who are more likely to fall, develop cardiovascular diseases, or cancer [31], and also significantly increases the risk of mortality of any cause [32][33][34].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Orthostatic Hypotension in Cancer Patients

Iwański,

Sokołowska,

Sokołowski

et al. 2024

Cancers

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Background: Orthostatic hypotension (OH) is associated with a higher risk of mortality in the general population; however, it has not been studied in the cancer population. This study aimed to assess the prevalence of OH in cancer patients compared to that in the noncancer population. Methods: A total of 411 patients (mean age 63.5 ± 10.6 years) were recruited: patients with active cancer (n = 223) and patients hospitalised for other reasons, but without a cancer diagnosis (n = 188). Medical histories were collected and an orthostatic challenge test was performed. OH was defined as a blood pressure (BP) decrease upon standing of ≥20 mmHg for the systolic or ≥10 mmHg for the diastolic BP after 1 or 3 min; or a systolic BP decrease <90 mmHg. Results: The prevalence of OH in the subjects with cancer was significantly higher than in the subjects without cancer (28.7% vs. 16.5%, respectively, p = 0.003). OH was the most common in the lung cancer patients (57.5%). In a single-variable analysis, the predictors of OH were cancer presence, age ≥ 65 years, and body mass index (BMI) ≥ 30 kg/m2. In the multivariable model, the strongest independent predictor of OH was cancer status, which doubled the risk of OH, and BMI ≥ 30 kg/m2 and diabetes. Conclusions: Cancer patients are characterised by a high prevalence of OH. In this population, the recommendation of routine orthostatic challenge tests should be considered.

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“…Due to the lower mortality experience, clinicians often tended to neglect people complaining about chronic hypotension and label it as a non-disease [ 15 ] despite the observed association with considerable morbidity at the community level seen in the later studies. Although the most affected are younger people with a preponderance of women, hypotension in the elderly does carry some health risks as hypotension (mostly orthostatic) has been found to be associated with cognitive decline, dementia, falls, stroke and increase in overall mortality in more recent studies [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Hypotension and Environmental Noise: A Replication Study

Widmann¹,

Thudium

2014

IJERPH

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Up to now, traffic noise effect studies focused on hypertension as health outcome. Hypotension has not been considered as a potential health outcome although in experiments some people also responded to noise with decreases of blood pressure. Currently, the characteristics of these persons are not known and whether this down regulation of blood pressure is an experimental artifact, selection, or can also be observed in population studies is unanswered. In a cross-sectional replication study, we randomly sampled participants (age 20–75, N = 807) from circular areas (radius = 500 m) around 31 noise measurement sites from four noise exposure strata (35–44, 45–54, 55–64, >64 Leq, dBA). Repeated blood pressure measurements were available for a smaller sample (N = 570). Standardized information on socio-demographics, housing, life style and health was obtained by door to door visits including anthropometric measurements. Noise and air pollution exposure was assigned by GIS based on both calculation and measurements. Reported hypotension or hypotension medication past year was the main outcome studied. Exposure-effect relationships were modeled with multiple non-linear logistic regression techniques using separate noise estimations for total, highway and rail exposure. Reported hypotension was significantly associated with rail and total noise exposure and strongly modified by weather sensitivity. Reported hypotension medication showed associations of similar size with rail and total noise exposure without effect modification by weather sensitivity. The size of the associations in the smaller sample with BMI as additional covariate was similar. Other important cofactors (sex, age, BMI, health) and moderators (weather sensitivity, adjacent main roads and associated annoyance) need to be considered as indispensible part of the observed relationship. This study confirms a potential new noise effect pathway and discusses potential patho-physiological routes of actions.

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Morbidity and mortality related to orthostatic hypotension: results of a meta-analysis of non-randomized observational studies

Cited by 3 publications

References 0 publications

The Prevalence of Orthostatic Hypotension in Cancer Patients

The Prevalence of Orthostatic Hypotension in Cancer Patients

The Prevalence of Orthostatic Hypotension in Cancer Patients

Hypotension and Environmental Noise: A Replication Study

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