Orthostatic hypotension did not independently predict coronary events (adjusted RR 1.25; 95% CI 0.82-1.88) or other cardiovascular outcomes after adjusting for age, gender, and systolic blood pressure.
Cohort (n=1,016)
Does orthostatic hypotension increase the risk of cardiovascular events in elderly individuals?
Orthostatic hypotension does not independently predict cardiovascular events in the elderly when adjusting for biological confounders like age and systolic blood pressure.
Relative Risk: 1.25 (95% CI 0.82–1.88)
Absolute Event Rate: 20.2% vs 13.1%
p-value: p=0.05
BACKGROUND: The general belief that orthostatic hypotension (OH) predisposes to cardiovascular events is based on sparse and contradictory data, rarely derived from population studies. METHODS: A total of 1,016 men and women aged ≥65 years was studied in a 12-year epidemiological population-based study. Cardiovascular events were detected in subjects with and without OH (blood pressure (BP) decrease ≥20mm Hg for systolic or ≥10mm Hg for diastolic), and Cox analysis was performed including OH as an independent variable. RESULTS: In univariate analysis, coronary (20.2% vs. 13.1%, P = 0.05), cerebrovascular (13.1% vs. 8.4%, P = 0.05), and heart failure (HF) events (20.2% vs. 13.8%, P = 0.03) were apparently more incidental in subjects with OH than in those without OH. Nevertheless, after adjusting for age, gender, and systolic BP as confounders, OH did not act as a cardiovascular predictor (relative risk for cerebrovascular events 1.33, 95% confidence interval (CI), 0.78-2.2, for coronary events 1.25, CI 0.82-1.88, for HF 1.07, CI 0.71-1.62, for arrhythmias 0.82, CI 0.40-1.37, and for syncope 0.58, CI 0.13-2.71). CONCLUSIONS: Although OH seems to be a predictor of coronary, cerebrovascular, and HF events, no predictive role was found in models that include biological confounders. Independent of the cause of OH, age and systolic BP, which are positively associated with OH, fully explain the greater incidence of cardiovascular events and the greater cardiovascular risk observed in subjects with OH.
Casiglia et al. (Mon,) conducted a cohort in Orthostatic hypotension (n=1,016). Orthostatic hypotension vs. Subjects without orthostatic hypotension was evaluated on Coronary events (RR 1.25, 95% CI 0.82-1.88, p=0.05). Orthostatic hypotension did not independently predict coronary events (adjusted RR 1.25; 95% CI 0.82-1.88) or other cardiovascular outcomes after adjusting for age, gender, and systolic blood pressure.
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