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Lookup NU author(s): Professor Sheena Ramsay
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2020 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC. The mechanisms underlying the association between orthostatic hypotension (OH) and cardiovascular disease are unclear. We investigated whether OH is associated with circulating cardiovascular risk markers. This was a cross-sectional analysis of 3857 older, community-dwelling men. “Consensus OH” was defined as a sitting-to-standing decrease in systolic blood pressure ≥20 mm Hg and/or diastolic blood pressure ≥10 mm Hg that occurred within three minutes of standing. Multiple generalized linear regression and logistic models were used to examine the association between cardiovascular risk markers and OH. Consensus OH was present in 20.2%, consisting of isolated systolic OH in 12.6%, isolated diastolic OH in 4.6%, and combined systolic and diastolic OH in 3.0%. Concentration of von Willebrand factor, a marker of endothelial dysfunction, was positively associated with isolated systolic OH (OR 1.35, 95% CI 1.05-1.73) and combined systolic and diastolic OH (OR 2.27, 95% CI 1.35-3.83); high circulating phosphate concentration, which may reflect vascular calcification, was associated with isolated diastolic OH (OR 1.53, 95% CI 1.04-2.25) and combined systolic and diastolic OH (OR 2.12, 95% CI 1.31-3.44), high-sensitivity troponin T, a marker of myocardial injury, was positively associated with isolated diastolic OH (OR 1.69, 95% CI 1.07-2.65) and N-terminal pro-brain natriuretic peptide, a marker of cardiac stress, was positively associated with combined systolic and diastolic OH (OR 2.14, 95% CI 1.14-4.03). In conclusion, OH is associated with some cardiovascular risk markers implicated in endothelial dysfunction, vascular calcification, myocardial injury, and cardiac stress. Clinicians should consider assessing cardiovascular risk in patients with OH.
Author(s): Gilani A, Ramsay SE, Juraschek SP, Papacosta O, Lennon LT, Whincup PH, Wannamethee SG
Publication type: Article
Publication status: Published
Journal: Journal of Clinical Hypertension
Year: 2020
Volume: 22
Issue: 10
Pages: 1892-1901
Print publication date: 01/10/2020
Online publication date: 16/08/2020
Acceptance date: 28/06/2020
Date deposited: 15/10/2020
ISSN (print): 1524-6175
ISSN (electronic): 1751-7176
Publisher: Wiley Periodicals, Inc.
URL: https://doi.org/10.1111/jch.13996
DOI: 10.1111/jch.13996
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