Orthostatic Changes in Blood Pressure and Mortality in the Elderly: The Pro.V.A Study.

Content Provider	Semantic Scholar
Author	Veronese, Nicola Rui, Marina De Bolzetta, Francesco Yoshihara, Akihiro Corti, María Chiara Baggio, Giovanella Toffanello, Elena Debora Maggi, Stéphane Crepaldi, Gabriel Armond Perissinotto, Egle Manzato, Elodie Sergi, Giuseppe
Copyright Year	2015
Abstract	BACKGROUND An extensive, albeit contrasting literature has suggested a possible role for orthostatic hypotension as a risk factor for cardiovascular (CVD) and non-CVD mortality, while no data are available for orthostatic hypertension. We investigated whether orthostatic changes in blood pressure (BP) were associated with any increased risk of all-cause, CVD or non-CVD mortality in a group of elderly people. METHODS Two thousand seven hundred and eighty six community-dwelling older participants were followed for 4.4 years. Participants were grouped according to whether they had a drop ≤20 mm Hg in systolic, or ≤10 mm Hg in diastolic BP (orthostatic hypotension), an increase in mean orthostatic systolic BP ≥20 (orthostatic hypertension), or normal changes within 3 minutes of orthostatism. RESULTS During follow-up, 640 subjects died, 208 of them for CVD-related reasons. Adjusted Cox's regression analysis revealed that, compared with normal changes, orthostatic hypertension was associated with higher all-cause (HR = 1.23; 95% CI: 1.02-1.39) and CVD-related mortality (HR = 1.41; 95% CI: 1.08-1.74), while orthostatic hypotension was only associated with a higher non-CVD mortality (HR = 1.19; 95% CI: 1.01-1.60). Orthostatic hypertension emerged as a predictor of all-cause mortality for: participants over 75 years old; participants with a BMI below 25 kg/m2; participants with no CVD or disabilities; and those taking less than three medications. Orthostatic hypertension also predicted CVD-related mortality in individuals with no hypertension, heart failure, coronary artery disease, or atrial fibrillation. CONCLUSIONS Orthostatic hypertension and hypotension both seem to be relevant risk factors for mortality in the elderly, orthostatic hypertension correlating with all-cause and CVD-related mortality and orthostatic hypotension with non-CVD mortality.
Starting Page	26
Ending Page	27
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PubMed reference number	25767137v1
Alternate Webpage(s)	https://doi.org/10.1093/ajh/hpv022
DOI	10.1093/ajh/hpv022
Journal	American journal of hypertension
Volume Number	28
Issue Number	10
Language	English
Access Restriction	Open
Subject Keyword	Arteriopathic disease Atrial Fibrillation Cardiovascular Diseases Cessation of life Coronary Artery Disease Diastole Heart Atrium Heart failure Kilogram Per Square Meter Shy-Drager Syndrome orthostatic hypertension
Content Type	Text
Resource Type	Article