HypertensionMeta-analysis
Orthostatic Hypotension, Hypertension Treatment, and Cardiovascular Disease
- Individual participant data meta-analysis of randomised trials
- systematic review
- single-stage Cox proportional hazards models
Authors' conclusion
In this population of hypertension trial participants, intensive therapy reduced risk of CVD or all-cause mortality regardless of orthostatic hypotension without evidence for different effects among those with standing hypotension.
Study context
- Population
- Participants of randomised blood pressure (BP)-treatment trials with orthostatic hypotension assessments (mean age 69.0 years; 48% women)
- Participants
- 29,235 participants · 9 trials
- Comparison
- More intensive BP goal or active therapy vs standard BP goal or placebo, by baseline orthostatic or standing hypotension
- Outcome
- Cardiovascular disease (CVD) or all-cause mortality
- Follow-up
- Median 4 years
Pooled result
As reported in the abstract
CVD or all-cause mortality, by baseline orthostatic and standing hypotension (subgroups)
More intensive BP treatment or active therapy vs Standard BP goal or placeboHazard ratio (95% CI)
without baseline orthostatic hypotension
0.81(0.76–0.86)
with baseline orthostatic hypotension
0.83(0.70–1.00)
without baseline standing hypotension
0.80(0.75–0.85)
with baseline standing hypotension
0.94(0.75–1.18)
Original publication
Orthostatic Hypotension, Hypertension Treatment, and Cardiovascular Disease. JAMA. Published 17 October 2023. doi:10.1001/jama.2023.18497
Summarised from the published abstract; every number is checked against it