Orthostatic Hypotension, Hypertension Treatment, and Cardiovascular Disease: An Individual Participant Meta-Analysis
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
Methodological detailssystematic review, single-stage Cox proportional hazards models
- Systematic review
- Single-stage Cox proportional hazards models
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: An Individual Participant Meta-Analysis. JAMA. Published 17 October 2023. doi:10.
Summarised from the published abstract; every number is checked against it