Population-Based Study on the Prevalence and Correlates of Orthostatic Hypotension/Hypertension and Orthostatic Dizziness

Wu, Jin Shang; Yang, Yi Ching; Lu, Feng Hwa; Wu, Chih Hsiung; Chang, Chih Jen

doi:10.1291/hypres.31.897

Cited by 117 publications

(103 citation statements)

References 36 publications

(57 reference statements)

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“…Orthostatic hypotension (OH) is common in adults with hypertension1, 2, 3 and diabetes mellitus4 and is associated with several adverse health outcomes, including falls, syncope, and death 5. Although OH has been associated with change in heart structure over time, suggestive of a causal relationship,6 the association between OH and cardiovascular disease (CVD) in the literature is inconsistent.…”

mentioning

confidence: 99%

Orthostatic Hypotension and Risk of Clinical and Subclinical Cardiovascular Disease in Middle‐Aged Adults

Juraschek

Daya

Appel

et al. 2018

JAHA

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BackgroundAlthough orthostatic hypotension (OH) is a well‐recognized manifestation of neuropathy and hypovolemia, its contribution to cardiovascular disease (CVD) risk is controversial.Methods and ResultsParticipants with OH, defined as a decrease in blood pressure (systolic ≥20 mm Hg or diastolic ≥10 mm Hg) from the supine to standing position, were identified during the first visit of the ARIC (Atherosclerosis Risk in Communities) Study (1987–1989) within 2 minutes of standing. All participants were followed up for the development of myocardial infarction, heart failure, stroke, fatal coronary heart disease (CHD), any CHD (combination of silent, nonfatal, and fatal CHD or cardiac procedures), and all‐cause mortality. Participants were assessed for carotid intimal thickness and plaque during the first visit. Detectable high‐sensitivity troponin T (≥5 ng/L) and elevated NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide; ≥100 pg/mL) were determined in blood collected during the second visit (1990–1992). All associations were adjusted for known CVD risk factors. In 9139 participants (57% women; 23% black; mean age, 54±5.7 years), 3% had OH. During follow‐up (median, 26 years), OH was associated with myocardial infarction (hazard ratio [HR], 1.88; 95% confidence interval [CI], 1.44–2.46), congestive heart failure (HR, 1.65; 95% CI, 1.34–2.04), stroke (HR, 1.83; 95% CI, 1.35–2.48), fatal CHD (HR, 2.77; 95% CI, 1.93–3.98), any CHD (HR, 2.00; 95% CI, 1.64–2.44), and all‐cause mortality (HR, 1.68; 95% CI, 1.45–1.95). OH was also associated with carotid intimal thickness (β, 0.05 mm; 95% CI, 0.04–0.07 mm), carotid plaque (odds ratio, 1.51; 95% CI, 1.18–1.93), detectable high‐sensitivity troponin T (odds ratio, 1.49; 95% CI, 1.16–1.93), and elevated NT‐proBNP (odds ratio, 1.92; 95% CI, 1.48–2.49).Conclusions OH identified in community‐dwelling middle‐aged adults was associated with future CVD events and subclinical CVD. Further research is necessary to establish a causal role for OH in the pathogenesis of CVD.

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confidence: 99%

Orthostatic Hypotension and Risk of Clinical and Subclinical Cardiovascular Disease in Middle‐Aged Adults

Juraschek

Daya

Appel

et al. 2018

JAHA

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“…Our study mirrored the previous findings that the OHP patients have higher supine BP compared to the OHN patients. 2 The OHN group displayed normal physiological responses by having compensatory rises in BP and PR to the gravitational effects of standing, and this effect was sustained over time. However, OHP patients lacked this expected compensatory rise in BP.…”

Section: Discussionmentioning

confidence: 93%

“…Previous studies have found similar results that suggested that only 30% to 40% of patients with OH would manifest typical symptoms while the others remained asymptomatic or had atypical symptoms. [2][3][4] This makes the diagnosis of OH difficult, and thus routine measurements are required to vigilantly detect cases.…”

Section: Discussionmentioning

confidence: 99%

“…1 It is a physical sign and is not always associated with symptoms. [2][3][4] The reported prevalence of OH ranges from 6% in healthy elderly community dwellers to 68% in hospitalized geriatric patients. 5 The prevalence of OH across emergency department presentations is about 3% to 25%.…”

Section: Introductionmentioning

confidence: 99%

“…13 Furthermore, the literature regarding risk factors (including medications) for the development of OH has been inconclusive, with various studies yielding different results. 2,12,14 This descriptive observational cohort study was conducted with the primary aim to identify the spot prevalence of OH in the medical, surgical, and trauma wards of an acute tertiary hospital using routine noninvasive blood pressure (BP) monitoring methods available in the ward setting.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence, Associations and Risk Factors for Orthostatic Hypotension in Medical, Surgical and Trauma Inpatients: An Observational Cohort Study

Aung

Corcoran

Nagalingam

et al. 2011

Heart, Lung and Circulation

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Background: Orthostatic hypotension (OH) is prevalent in hospitalized elderly patients. It is defined as a reduction in systolic blood pressure (SBP) of at least 20 mmHg and/or diastolic blood pressure (DBP) of at least 10 mmHg within 3 minutes of standing from a lying position. This observational cohort study describes the prevalence, association with symptoms, and risk factors for OH in medical, surgical, and trauma wards in a tertiary hospital and the differences in hemodynamic behaviors between OH-positive (OHP) and OH-negative (OHN) patients. Methods: All 76 patients who were hemodynamically stable and able to stand from 4 hospital wards had noninvasive supine and orthostatic blood pressures (BPs) and pulse rates (PRs) measured over 4 days. Results: Mean age of the 76 patients included in the study was 67.8 6 19.6 years. Overall prevalence of OH was 23.7% (95% CI: 14.7%-34.8%) with 21.2% (95% CI: 9.0%-38.9%) in medical, 31.8% (95% CI: 13.9%-54.9%) in surgical, and 19.0% (95% CI: 5.4%-41.9%) in trauma wards. OH had no association with symptoms (P 5 .53). We found no differences in age, number of comorbidities, and medication use between the OHN and OHP groups.The two groups displayed very different hemodynamic responses. The OHN group demonstrated a statistically significant compensatory rise in BP and PR over time to orthostatic

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Hypotension

Alakkassery¹

2012

Cardiovascular Disease and Health in the Older Patient

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Population-Based Study on the Prevalence and Correlates of Orthostatic Hypotension/Hypertension and Orthostatic Dizziness

Cited by 117 publications

References 36 publications

Orthostatic Hypotension and Risk of Clinical and Subclinical Cardiovascular Disease in Middle‐Aged Adults

Orthostatic Hypotension and Risk of Clinical and Subclinical Cardiovascular Disease in Middle‐Aged Adults

Prevalence, Associations and Risk Factors for Orthostatic Hypotension in Medical, Surgical and Trauma Inpatients: An Observational Cohort Study

Hypotension

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