What question did this study set out to answer?

This study aims to examine the prognostic impact of orthostatic hypertension on cardiovascular health and mortality in old institutionalized adults.

November 24, 2015Hypertension

Evidence for a Prognostic Role of Orthostatic Hypertension on Survival in a Very Old Institutionalized Population

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Why the study?

Does orthostatic hypertension increase cardiovascular morbidity and mortality in very old institutionalized subjects?

Key Points

This study aims to examine the prognostic impact of orthostatic hypertension on cardiovascular health and mortality in old institutionalized adults.
Conducted a 2-year follow-up longitudinal study on 972 institutionalized subjects aged 88 on average.
Defined orthostatic hypertension as a ≥20 mm Hg increase in systolic blood pressure during standing.
Compared three groups: orthostatic normotension, orthostatic hypotension, and orthostatic hypertension.
Orthostatic hypertension was associated with a 51% increased risk of cardiovascular morbidity and mortality (HR 1.51, 95% CI 1.09-2.08, P<0.01) compared to normotension.
The prevalence of orthostatic hypertension (28%) was higher than orthostatic hypotension (16%).
No significant differences in cardiovascular outcomes were found between orthostatic hypertension and orthostatic hypotension groups.

Structured PICO

Does orthostatic hypertension increase cardiovascular morbidity and mortality in very old institutionalized subjects?

Population

972 very old institutionalized subjects (mean age 88, SD 5) from the PARTAGE study, able to maintain a standing position.

Intervention

Orthostatic hypertension (OHyperT), defined as an increase in systolic blood pressure ≥20 mm Hg during the first and third minute of standing.

Comparator

Orthostatic normotension (n=540) and orthostatic hypotension (OHypoT, n=157).

Outcome

Cardiovascular morbidity and mortality.composite

In a very old institutionalized population, orthostatic hypertension is common and independently associated with increased cardiovascular morbidity and mortality compared to orthostatic normotension.

Discussion

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Implication

Orthostatic hypertension may flag higher risk in very old institutionalized adults; hypothesis-generating and requires prospective confirmation before practice change.

Cite This Study

Agnoletti et al. (2015) studied this question.

synapsesocial.com/papers/6a2bca4213775535c8964592 https://doi.org/10.1161/hypertensionaha.115.06386

Topics

Hypertension management

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Implication

Orthostatic hypertension may flag higher risk in very old institutionalized adults; hypothesis-generating and requires prospective confirmation before practice change.

Evidence for a Prognostic Role of Orthostatic Hypertension on Survival in a Very Old Institutionalized Population

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Evidence for a Prognostic Role of Orthostatic Hypertension on Survival in a Very Old Institutionalized Population

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider