Orthostatic Hypotension Predicts Mortality in Middle-Aged Adults The Atherosclerosis Risk in Communities (ARIC) Study

University of Arkansas at Little Rock, Little Rock, Arkansas, United States
Circulation (Impact Factor: 14.95). 09/2006; 114(7):630-6. DOI: 10.1161/CIRCULATIONAHA.105.598722
Source: PubMed

ABSTRACT An association between orthostatic hypotension (OH) and mortality has been reported, but studies are limited to older adults or high-risk populations.
We investigated the association between OH (a decrease of 20 mm Hg in systolic blood pressure or a decrease of 10 mm Hg in diastolic blood pressure on standing) and 13-year mortality among middle-aged black and white men and women from the Atherosclerosis Risk in Communities Study (1987-1989). At baseline, 674 participants (5%) had OH. All-cause mortality was higher among those with (13.7%) than without (4.2%) OH. After we controlled for ethnicity, gender, and age, the hazard ratio (HR) for OH for all-cause mortality was 2.4 (95% confidence interval [CI], 2.1 to 2.8). Adjustment for risk factors for cardiovascular disease and mortality and selected health conditions at baseline attenuated but did not completely explain this association (HR = 1.7; 95% CI, 1.4 to 2.0). This association persisted among subsets that (1) excluded those who died within the first 2 years of follow-up and (2) were limited to those without coronary heart disease, cancer, stroke, diabetes, hypertension, or fair/poor perceived health status at baseline. In analyses by causes of death, a significant increased hazard of death among those with versus without OH persisted after adjustment for risk factors for cardiovascular disease (HR = 2.0; 95% CI, 1.6 to 2.7) and other deaths (HR = 2.1; 95% CI, 1.6 to 2.8) but not for cancer (odds ratio = 1.1; 95% CI, 0.8 to 1.6).
OH predicts mortality in middle-aged adults. This association is only partly explained by traditional risk factors for cardiovascular disease and overall mortality.

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    • "Hypotension, including orthostatic hypotension, is associated with significant morbidity and mortality (Mukai and Lipsitz 2002). Furthermore, it has been identified as serious risk factor for stroke and coronary artery disease in the elderly (Eigenbrodt et al. 2000; Jones et al. 2012; Masaki et al. 1998; Rose et al. 2006). Fedorowski et al. (2010) reported an increased risk for cardiac events and all-cause mortality in middle-aged individuals suffering from hypotension. "
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