Abstract | BACKGROUND: The prevalence and clinical significance of orthostatic hypertension (OHT) remain largely undetermined in hypertensive patients. This study investigated the association of OHT and orthostatic hypotension ( OH) with cardiovascular disease (CVD) and target organ damage (TOD) in hypertensive patients. METHODS: A cross-sectional study was conducted in 4,711 hypertensives and 826 normotensives, aged 40-75 years. OHT was defined as an increase in systolic blood pressure (SBP) of > or =20 mm Hg, and OH was defined as either a reduction in SBP of at least 20 mm Hg or a reduction in diastolic BP (DBP) of at least 10 mm Hg during the first 3 min after standing. RESULTS:
Hypertension was only independently associated with a risk of OHT. After controlling for age, sex, and other confounders, OH was associated with peripheral artery disease (PAD) (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.15-1.89, P < 0.01), left ventricular hypertrophy (LVH) (OR 1.48, 95% CI 1.12-1.93, P < 0.001), coronary artery disease (CAD) (OR 1.71, 95% CI 1.12-2.61, P < 0.01), and stroke (OR 1.72, 95% CI 1.19-2.34, P < 0.01), but OHT was only associated with PAD (OR 1.36, 95% CI 1.05-1.81, P < 0.05) and stroke (OR 1.76, 95% CI 1.27-2.26, P < 0.01). The adjusted OR for PAD, predicted by the quintiles of the orthostatic SBP changes, showed a J-shaped relationship in untreated hypertensive patients, as was also the case for LVH in hypertensive women. CONCLUSIONS:
OH is associated with CV risk; the associations of OHT with TOD and stroke in hypertensive patients still need to be confirmed in prospective studies.
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Authors | Xiao-Han Fan, Yibo Wang, Kai Sun, Weili Zhang, Hu Wang, Haiying Wu, Huimin Zhang, Xianliang Zhou, Rutai Hui |
Journal | American journal of hypertension
(Am J Hypertens)
Vol. 23
Issue 8
Pg. 829-37
(Aug 2010)
ISSN: 1941-7225 [Electronic] United States |
PMID | 20414196
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Aged
- Blood Pressure
(physiology)
- Cardiovascular Diseases
(etiology)
- Coronary Disease
(etiology)
- Cross-Sectional Studies
- Female
- Humans
- Hypertension
(complications, epidemiology, etiology)
- Hypertrophy, Left Ventricular
(etiology)
- Hypotension, Orthostatic
(complications, epidemiology)
- Male
- Middle Aged
- Peripheral Vascular Diseases
(etiology)
- Posture
- Prevalence
- Stroke
(etiology)
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