In a nutshell
This study investigated if orthostatic hypotension (OH) is associated with cardiovascular events (CVEs) in patients treated for hypertension (high blood pressure).
They found that OH is not associated with CVEs in these patients.
Some background
Hypertension or high blood pressure (BP) is a serious condition. BP levels should be managed to prevent cardiovascular events (CVEs). CVEs include stroke and heart attacks. Hypertension can be treated with anti-hypertensive (AHT) drugs. The standard target for treatment is to reach a systolic BP (SBP) of 140 mmHg. Orthostatic hypotension (OH) is common in older adults treated for hypertension. OH is described as a sudden drop in BP after standing.
The treatment of OH is to adjust the AHT regimen. Some studies suggest aiming for a target SBP of 120 mmHg reduces CVE risk. This target may also reduce the risk of OH. The role of OH in the risk of CVEs is unclear. It is also unclear if OH risk is reduced at a lower BP target.
Methods & findings
This study included 8792 patients with hypertension. These patients had a high risk of CVD. Patients were randomly selected to undergo AHT treatment. One group had a target SBP of 140 mmHg. The second group had a SBP target of 120 mmHg. OH was assessed at the beginning of the study, at 1, 6 and 12 months, and yearly thereafter. The main outcome was the occurrence of CVEs.The average follow-up time was 3 years.
18.5% of the patients had an OH episode during the study. The rates of OH were similar in 120 mmHg and 140mmHg target groups. OH was not associated with a higher CVE risk. OH was associated with a 77% higher rate of hypotension (low blood pressure) episodes. Bradycardia (slow heart rate) was also more common in patients with OH. OH was also associated with a higher rate of emergency department visits.
The bottom line
The authors concluded that OH is not associated with CVEs in patients treated for hypertension.
The fine print
Patients with conditions like diabetes and previous stroke were not included in this study. The effect of OH on CVEs may also be different. More studies are needed.
What’s next?
If you have any concerns regarding hypertension management please discuss this with your physician.
Published By :
Hypertension (Dallas, Tex. : 1979)
Date :
Jan 27, 2020
