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- Title
Disorders of Orthostatic Blood Pressure Response Are Associated With Cardiovascular Disease and Target Organ Damage in Hypertensive Patients.
- Authors
Xiao-Han Fan; Yibo Wang; Kai Sun; Weili Zhang; Hu Wang; Haiying Wu; Huimin Zhang; Xianliang Zhou; Rutai Hui
- Abstract
BackgroundThe prevalence and clinical significance of orthostatic hypertension (OHT) remain largely undetermined in hypertensive patients. This study investigated the association of OHT and orthostatic hypotension (OH) with cardiovascular disease (CVD) and target organ damage (TOD) in hypertensive patients.MethodsA cross-sectional study was conducted in 4,711 hypertensives and 826 normotensives, aged 40–75 years. OHT was defined as an increase in systolic blood pressure (SBP) of ≥20 mm Hg, and OH was defined as either a reduction in SBP of at least 20 mm Hg or a reduction in diastolic BP (DBP) of at least 10 mm Hg during the first 3 min after standing.ResultsHypertension was only independently associated with a risk of OHT. After controlling for age, sex, and other confounders, OH was associated with peripheral artery disease (PAD) (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.15–1.89, P < 0.01), left ventricular hypertrophy (LVH) (OR 1.48, 95% CI 1.12–1.93, P < 0.001), coronary artery disease (CAD) (OR 1.71, 95% CI 1.12–2.61, P < 0.01), and stroke (OR 1.72, 95% CI 1.19–2.34, P < 0.01), but OHT was only associated with PAD (OR 1.36, 95% CI 1.05–1.81, P < 0.05) and stroke (OR 1.76, 95% CI 1.27–2.26, P < 0.01). The adjusted OR for PAD, predicted by the quintiles of the orthostatic SBP changes, showed a J-shaped relationship in untreated hypertensive patients, as was also the case for LVH in hypertensive women.ConclusionsOH is associated with CV risk; the associations of OHT with TOD and stroke in hypertensive patients still need to be confirmed in prospective studies.American Journal of Hypertension 2010; doi:10.1038/ajh.2010.76
- Subjects
HYPERTENSION; BLOOD pressure; ORTHOSTATIC hypotension; HYPERTROPHY; ARTERIAL diseases; CONFIDENCE intervals
- Publication
American Journal of Hypertension, 2010, Vol 23, Issue 8, p829
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1038/ajh.2010.76