Orthostatic Hypotension and the Risk of Congestive Heart Failure: A Meta-Analysis of Prospective Cohort Studies

Abstract

BackgroundOrthostatic hypotension (OH) has been related to the increased risk of future congestive heart failure (CHF) events. However, the overall quantitative estimate of predictive ability of OH for CHF has not been determined. We therefore performed a meta-analysis to investigate the association between OH and incident CHF.MethodsProspective cohort studies relevant to the aim of the study were identified by searching of Medline and Embase databases up to December 25, 2012 without restrictions and by reviewing the reference lists from retrieved articles.ResultsA total of 51270 subjects and 3603 incident CHF cases from 4 prospective cohorts were included in the meta-analysis. Using random effect model, the pooled result indicated that presence of OH at baseline was significantly associated with an increased risk for future CHF outcomes (adjusted hazard ratio: 1.30, 95% confidence interval 1.09–1.55; p = 0.004). Results of stratified analysis suggested that the association between OH and CHF incidence seemed to be significant in middle-age subjects, or the individuals with hypertension and diabetes at baseline, but did not significant in the elderly subjects or those without hypertension or diabetes.ConclusionsOur meta-analysis confirmed that presence of OH is related to a significant increased risk for development of CHF in the future. Studies are needed to explore the potential mechanisms underlying this association. More importantly, screen for OH may be of great clinical significance for the early identification of subjects at higher risk for development of CHF.

Grading of Left Ventricular Diastolic Dysfunction with Preserved Systolic Function by the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging Recommendations Contributes to Predicting Cardiovascular Events in Hemodialysis Patients

“…Furthermore, postdialysis orthostatic hypotension at least once a week increased proportionally with diastolic function grades. Recent studies including a meta-analysis identified orthostatic hypotension as a risk factor for HF and associated mortality in a general population [18, 19]. Furthermore, in the present prospective cohort study, the DD grade and PS were associated with MACE.…”

Hipotensão Ortostática E O Risco De Doenças Cardiovasculares Em Idosos: Uma Revisão De Literatura

“…(14,16,17,20) Jones et al, (17) se basearam na hipótese de que a hipotensão ortostática (HO) em adultos de meia--idade estaria associada a incidentes de insuficiência cardíaca (IC). Para se chegar a um resultado, foi realizado um estudo em curso longitudinal, com participantes do sexo masculino e feminino, com idades entre 45 e 64 anos, no qual se buscou avaliar se a HO está associada à IC em pacientes da raça negra e branca assim como avaliar a relação da contribuição de medicamentos específicos e os fatores de risco para a IC.…”

“…(3,15,(17)(18)(19) A meta-análise realizada por Wei Xin et al, (16) Portanto, em relação à faixa etária, os resultados diferentes sugerem que mecanismos separados podem ser responsáveis pela hipotensão ortostáti-ca em idosos em comparação com grupos etários mais jovens. (16,20,21) CONCLUSÃO A Hipotensão Ortostática (HO) é um fator de risco para o desenvolvimento de doenças cardiovasculares, principalmente Infarto do Miocárdio e Insuficiência Cardíaca Congestiva em pessoas de meia-idade, entretanto, identificou-se a carência de estudos voltados a indivíduos idosos.…”

Pharmacotherapy of Arterial Hypertension in Elderly Patients: Focus on Octogenarians

“…Ортостатическая гипотензия является фактором риска развития у пожилых больных застойной сердечной недостаточности [39], некардиальной смертности [40], падений и синкопальных состояний [5]. Риск развития ОГ наиболее высок при применении α-адреноблока-торов, нифедипина короткого действия, препаратов миотропного действия и центрального действия, а также αβ-блокаторов (карведилол, лабеталол).…”