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- Title
Orthostatic Hypotension and Risk of Cardiovascular Disease in Elderly People: The Rotterdam Study.
- Authors
Verwoert, Germaine C.; Mattace-Raso, Francesco U. S.; Hofman, Albert; Heeringa, Jan; Stricker, Bruno H. C.; Breteler, Monique M. B.; Witteman, Jacqueline C. M.
- Abstract
OBJECTIVES: To determine the prognostic role of orthostatic hypotension for cardiovascular disease (CVD) and all-cause mortality in elderly people. DESIGN: Prospective study. SETTING: Community based. PARTICIPANTS: Five thousand sixty-four subjects from the Rotterdam study aged 55 and older. MEASUREMENTS: Orthostatic hypotension was measured using a Dinamap automatic blood pressure recorder. Orthostatic hypotension is defined as a decline in systolic blood pressure of 20 mmHg or more or a decline in diastolic blood pressure of 10 mmHg or more from supine to standing position at any of three measurements taken 1, 2, and 3 minutes after standing. RESULTS: At baseline, 901 subjects had orthostatic hypotension. During follow-up, 668 subjects had coronary heart disease (CHD) (mean follow-up 6.0 ± 3.5 years), and 1,835 subjects died (mean follow-up period 7.8 ± 3.8 years). Orthostatic hypotension increased the risk of CHD (hazard ratio (HR)=1.31, 95% confidence interval (CI)=1.08–1.57) and all-cause mortality (HR=1.22, 95% CI=1.09–1.36), in models adjusted for age and sex. The risk was slightly lower after additional adjustment for cardiovascular risk factors. In analyses stratified for age, the HRs for all-cause mortality were 1.80 (95% CI 1.25–2.60), 1.13 (0.89–1.42), and 1.27 (95% CI=1.11–1.44), in the first, second, and third tertile of age, respectively. CONCLUSION: Orthostatic hypotension increases the risk of CHD and all-cause mortality in elderly people. The risk of CVD and mortality is strongest in younger and very old subjects.
- Subjects
CARDIOVASCULAR diseases in old age; CARDIOVASCULAR diseases; ORTHOSTATIC hypotension; HEALTH status indicators; DISEASE risk factors; PHYSIOLOGY
- Publication
Journal of the American Geriatrics Society, 2008, Vol 56, Issue 10, p1816
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/j.1532-5415.2008.01946.x