Gilani, A; Ramsay, SE; Juraschek, SP; Papacosta, O; Lennon, LT; Whincup, PH; Wannamethee, SG
(2020)
Associations of the systolic and diastolic components of orthostatic hypotension with markers of cardiovascular risk in older men: A cross-sectional analysis from The British Regional Heart Study.
JOURNAL OF CLINICAL HYPERTENSION, 22 (10).
pp. 1892-1901.
ISSN 1524-6175
https://doi.org/10.1111/jch.13996
SGUL Authors: Whincup, Peter Hynes
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Abstract
The mechanisms underlying the association between orthostatic hypotension (OH) and cardiovascular disease are unclear. We investigated whether OH is associated with circulating cardiovascular risk markers. This was a cross‐sectional analysis of 3857 older, community‐dwelling men. “Consensus OH” was defined as a sitting‐to‐standing decrease in systolic blood pressure ≥20 mm Hg and/or diastolic blood pressure ≥10 mm Hg that occurred within three minutes of standing. Multiple generalized linear regression and logistic models were used to examine the association between cardiovascular risk markers and OH. Consensus OH was present in 20.2%, consisting of isolated systolic OH in 12.6%, isolated diastolic OH in 4.6%, and combined systolic and diastolic OH in 3.0%. Concentration of von Willebrand factor, a marker of endothelial dysfunction, was positively associated with isolated systolic OH (OR 1.35, 95% CI 1.05‐1.73) and combined systolic and diastolic OH (OR 2.27, 95% CI 1.35‐3.83); high circulating phosphate concentration, which may reflect vascular calcification, was associated with isolated diastolic OH (OR 1.53, 95% CI 1.04‐2.25) and combined systolic and diastolic OH (OR 2.12, 95% CI 1.31‐3.44), high‐sensitivity troponin T, a marker of myocardial injury, was positively associated with isolated diastolic OH (OR 1.69, 95% CI 1.07‐2.65) and N‐terminal pro‐brain natriuretic peptide, a marker of cardiac stress, was positively associated with combined systolic and diastolic OH (OR 2.14, 95% CI 1.14‐4.03). In conclusion, OH is associated with some cardiovascular risk markers implicated in endothelial dysfunction, vascular calcification, myocardial injury, and cardiac stress. Clinicians should consider assessing cardiovascular risk in patients with OH.
Item Type: | Article | ||||||||||||
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Additional Information: | © 2020 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. | ||||||||||||
Keywords: | cardiovascular disease, cardiovascular disease risk factors, epidemiology, hypertension, orthostatic hypotension, Cardiovascular System & Hematology, 1101 Medical Biochemistry and Metabolomics, 1102 Cardiorespiratory Medicine and Haematology, 1103 Clinical Sciences | ||||||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Population Health Research Institute (INPH) | ||||||||||||
Journal or Publication Title: | JOURNAL OF CLINICAL HYPERTENSION | ||||||||||||
ISSN: | 1524-6175 | ||||||||||||
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Publisher License: | Creative Commons: Attribution 4.0 | ||||||||||||
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Web of Science ID: | WOS:000560149100001 | ||||||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/112333 | ||||||||||||
Publisher's version: | https://doi.org/10.1111/jch.13996 |
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