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Associations of the systolic and diastolic components of orthostatic hypotension with markers of cardiovascular risk in older men: A cross‐sectional analysis from The British Regional Heart Study

Gilani, A; Ramsay, SE; Juraschek, SP; Papacosta, O; Lennon, LT; Whincup, PH; Wannamethee, SG; (2020) Associations of the systolic and diastolic components of orthostatic hypotension with markers of cardiovascular risk in older men: A cross‐sectional analysis from The British Regional Heart Study. The Journal of Clinical Hypertension (jch.1399) 10.1111/jch.13996. Green open access

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Abstract

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-tostanding 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.

Type: Article
Title: Associations of the systolic and diastolic components of orthostatic hypotension with markers of cardiovascular risk in older men: A cross‐sectional analysis from The British Regional Heart Study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jch.13996
Language: English
Additional information: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2020 The Authors.
Keywords: cardiovascular disease, cardiovascular disease risk factors, epidemiology, hypertension, orthostatic hypotension
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10108055
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