Orthostatic hypotension and the risk of incidental cardiovascular diseases: A meta-analysis of prospective cohort studies

Wei, Xin; Mi, Shuhua; Lin, Zhiqin; Wang, Hui; Wei, Wei

doi:10.1016/j.ypmed.2016.01.007

Cited by 36 publications

(25 citation statements)

References 28 publications

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“…Subgroup analysis showed that among the Chinese population, the pooled HR of the association between OH and CHD was 2.63 (95% CI 1.13‐6.15, P = 0.025, I 2 = 79.5%), indicating a stronger correlation than that among the total population. The results of this updated meta‐analysis corroborated findings from a previous systematic review . In a meta‐analysis of four studies, individuals with OH predicted a 30% higher risk for developing HF in the future than did those without OH .…”

Section: Discussionsupporting

confidence: 82%

“…The results of this updated meta-analysis corroborated findings from a previous systematic review. [11][12][13] In a meta-analysis of four studies, individuals with OH predicted a 30% higher risk for developing HF in the future than did those without OH. 12 Another meta-analysis including 13 prospective cohort studies demonstrated that OH was an independent predictor of increased mortality and HF and CHD.…”

Section: Discussionmentioning

confidence: 99%

“…OH is prevalent among the elderly population, with a pooled prevalence of 22.2%, but is often assessed and treated inadequately . Studies have reported effects of OH on cardiovascular diseases (CVD), cerebrovascular events, and mortality . However, OH as an independent risk factor for CVD has been controversial.…”

Section: Introductionmentioning

confidence: 99%

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Orthostatic hypotension and the risk of atrial fibrillation and other cardiovascular diseases: An updated meta‐analysis of prospective cohort studies

Min

Shi

Sun

et al. 2019

J of Clinical Hypertension

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The relationships between orthostatic hypotension (OH) and some kinds of cardiovascular disease are inconsistent among studies. This updated meta‐analysis was conducted in hopes of producing progress on this topic. A systematic database search was performed in electronic databases, including the Chinese Biomedical Database (CBM), PubMed, Web of Science, and the Cochrane Library. Summary hazard ratio (HR) estimates with 95% confidence intervals (CIs) were calculated by a random‐effects model. Statistical heterogeneity was assessed with Cochran's Q test and the I2 statistic. From 1462 potentially eligible records, 15 studies met the inclusion criteria. Subjects with OH had a high risk of heart failure (HF) and atrial fibrillation (AF) (pooled HR 1.34, 95% CI 1.17‐1.52, P < 0.001 and pooled HR 1.51, 95% CI 1.28‐1.79, P < 0.001, respectively). This meta‐analysis also showed significant associations between OH and the risks of developing coronary heart disease (CHD) (pooled HR 1.44, 95% CI 1.18‐1.75, P < 0.001) and myocardial infarction (MI) (pooled HR 1.52, 95% CI 1.12‐2.06, P = 0.008). Our study suggests that OH is positively associated with high risks of HF and AF. Moreover, it may be related to high risks of CHD and MI.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Orthostatic hypotension and the risk of atrial fibrillation and other cardiovascular diseases: An updated meta‐analysis of prospective cohort studies

Min

Shi

Sun

et al. 2019

J of Clinical Hypertension

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“…1 Symptoms include lightheadedness, fatigue, neck pain, presyncope, and syncope. 2,3 The causes can include both CNS and peripheral nervous system degeneration. 4 Dopamine replacement therapies have been implicated as well.…”

Section: Discussionmentioning

confidence: 99%

Effects of orthostatic hypotension on cognition in Parkinson disease

et al. 2017

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Objective: To investigate the relation between orthostatic hypotension (OH) and posturemediated cognitive impairment in Parkinson disease (PD) using a cross-sectional and withingroup design.Methods: Individuals without dementia with idiopathic PD included 18 with OH (PDOH) and 19 without OH; 18 control participants were also included. Neuropsychological tests were conducted in supine and upright-tilted positions. Blood pressure was assessed in each posture. Results:The PD groups performed similarly while supine, demonstrating executive dysfunction in sustained attention and response inhibition, and reduced semantic fluency and verbal memory (encoding and retention). Upright posture exacerbated and broadened these deficits in the PDOH group to include phonemic fluency, psychomotor speed, and auditory working memory. When group-specific supine scores were used as baseline anchors, both PD groups showed cognitive changes following tilt, with the PDOH group exhibiting a wider range of deficits in executive function and memory as well as significant changes in visuospatial function. Conclusions:Cognitive deficits in PD have been widely reported with assessments performed in the supine position, as seen in both our PD groups. Here we demonstrated that those with PDOH had transient, posture-mediated changes in excess of those found in PD without OH. These observed changes suggest an acute, reversible effect. Understanding the effects of OH due to autonomic failure on cognition is desirable, particularly as neuroimaging and clinical assessments collect data only in the supine or seated positions. Identification of a distinct neuropsychological profile in PD with OH has quality of life implications, and OH presents itself as a possible target for intervention in cognitive disturbance. Orthostatic hypotension (OH) is among the most commonly reported nonmotor manifestations in persons with Parkinson disease (PD), with prevalence as high as 53%.1 Symptoms include lightheadedness, fatigue, neck pain, presyncope, and syncope.2,3 The causes can include both CNS and peripheral nervous system degeneration.4 Dopamine replacement therapies have been implicated as well. 5OH is associated with cognitive impairment. Even when controlling for systolic blood pressure (SBP), both elderly and younger individuals with OH show relative deficits in verbal memory and sustained attention, both of which are predictors of subsequent cognitive decline that is greater than would be expected in the context of normal aging. 6Idiopathic PD is itself associated with cognitive deficits. Historically, these were thought to be limited to psychomotor/information processing speeds and caused by disease-specific subcortical pathologies.7 However, deficits across executive functions are present, even in cases without

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“…However, it sometimes may be asymptomatic and therefore often ignored by people . But studies have found that OH is harmful and causes a series of adverse outcomes including cardiovascular events or cerebrovascular events . Importantly, OH is prevalent in the elderly with incidences ranging from 5% to 30% and carries significant burdens for the aged .…”

Section: Introductionmentioning

confidence: 99%

The association between orthostatic hypotension and dementia: A meta‐analysis of prospective cohort studies

Min

Shi

Sun

et al. 2018

Int J Geriat Psychiatry

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Objectives As for the association between orthostatic hypotension (OH) and dementia, results of published studies are inconsistent; therefore, current substantive conclusions have yet been obtained. This meta‐analysis was conducted in hopes of producing progress in this topic. Methods A systematic database search was performed towards electronic databases including Chinese Biomedical Database, PubMed, Web of Science, Wiley Online Library, ScienceDirect, and the Cochrane Library. Five prospective cohort studies were included. Summary hazard ratio (HR) estimates with 95% confidence intervals (CIs) were calculated by random‐effects model. Statistical heterogeneity was assessed with the Cochran Q test and I2 statistic. A sensitivity analysis was also conducted in this meta‐analysis. Results A 22.4% higher prevalence of dementia in subjects with OH was obtained (adjusted pooled HR was 1.224; 95% CI: 1.106‐1.354; P < .001). This meta‐analysis also showed significant associations between OH and 2 dementia subtypes: Alzheimer disease (adjusted pooled HR was 1.175; 95% CI: 1.022‐1.351; P = .023) and Vascular dementia (adjusted pooled HR was 1.403; 95% CI: 1.042‐1.889; P = .026), respectively. Conclusions Orthostatic hypotension is positively associated with the overall prevalence of dementia, and it may contribute to the prevalence of Alzheimer disease and Vascular dementia as well.

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Orthostatic hypotension and the risk of incidental cardiovascular diseases: A meta-analysis of prospective cohort studies

Cited by 36 publications

References 28 publications

Orthostatic hypotension and the risk of atrial fibrillation and other cardiovascular diseases: An updated meta‐analysis of prospective cohort studies

Orthostatic hypotension and the risk of atrial fibrillation and other cardiovascular diseases: An updated meta‐analysis of prospective cohort studies

Effects of orthostatic hypotension on cognition in Parkinson disease

The association between orthostatic hypotension and dementia: A meta‐analysis of prospective cohort studies

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