HypertensionMeta-analysis
Effects of intensive blood pressure treatment on orthostatic hypertension: individual level meta-analysis
- Systematic review and individual participant data meta-analysis
Authors' conclusion
In this pooled cohort of adults with elevated blood pressure or hypertension, orthostatic hypertension was common and more intensive blood pressure treatment modestly reduced the occurrence of orthostatic hypertension.
Study context
- Population
- Adults ≥18 years with hypertension or elevated BP in RCTs (≥500 adults, duration ≥6 months)
- Participants
- 31,124 adults · 9 trials
- Comparison
- More intensive vs less intensive BP treatment
- Outcome
- Orthostatic hypertension (SBP rise ≥20 mm Hg or DBP rise ≥10 mm Hg from sitting to standing)
- Follow-up
- During
Pooled result
Orthostatic hypertension
Odds ratio
0.93
95% CI 0.90–0.96
By group
More intensive vs Less intensive
OR 0.93 (95% CI 0.90–0.96)
As reported in the abstract
Further pooled results
| Outcome | OR |
|---|---|
| Orthostatic hypertension, by race (subgroup) — More intensive vs Less intensive · non-black adults | 0.86 |
| Orthostatic hypertension, by race (subgroup) — More intensive vs Less intensive · black adults | 0.97 |
| Orthostatic hypertension, by diabetes (subgroup) — More intensive vs Less intensive · without diabetes | 0.88 |
| Orthostatic hypertension, by diabetes (subgroup) — More intensive vs Less intensive · with diabetes | 0.96 |
- Orthostatic hypertension, by race (subgroup): P for interaction=0.003
- Orthostatic hypertension, by diabetes (subgroup): P for interaction=0.05
Orthostatic BP status at baseline (single group)
- Orthostatic hypotension
- 9%
- Orthostatic hypertension
- 17%
- Rise in SBP and standing BP ≥140 mm Hg
- 3.2%
Orthostatic hypertension, other subgroups
- No difference by age ≥75 years, sex, baseline seated BP ≥130/≥80 mm Hg, obesity, stage 3 kidney disease, stroke, CVD, standing SBP ≥140 mm Hg or pre-randomization orthostatic hypertension
- P for interactions ≥0.05
Original publication
Effects of intensive blood pressure treatment on orthostatic hypertension: individual level meta-analysis. BMJ. Published 25 March 2025. doi:10.1136/bmj-2024-080507
Summarised from the published abstract; every number is checked against it