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.