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Orthostatic Hypotension Predicts Incidence of Heart Failure: The Malmö Preventive Project.

Fedorowski, Artur LU ; Engström, Gunnar LU ; Hedblad, Bo LU and Melander, Olle LU (2010) In American Journal of Hypertension 23. p.1209-1215
Abstract
BackgroundThe presence of orthostatic hypotension (OH) predicts all-cause mortality and incident cardiovascular disease. Whether or not OH is associated with the development of heart failure (HF) remains unknown.MethodsIn this Swedish population-based prospective study (the Malmö Preventive Project), the incidence of HF in relation to baseline OH, defined as decrease in systolic (SBP) >/=20 mm Hg and/or diastolic blood pressure (DBP) >/=10 mm Hg upon standing, was studied in 32,669 middle-aged individuals (68.2% men; mean age, 45.6 +/- 7.4 years) over a mean follow-up period of 24 years.ResultsAt baseline, 1,991 (6.1%) participants were found to have OH. During follow-up, 1,293 persons (4.0%, mean age at presentation: 67.9 +/- 7.9... (More)
BackgroundThe presence of orthostatic hypotension (OH) predicts all-cause mortality and incident cardiovascular disease. Whether or not OH is associated with the development of heart failure (HF) remains unknown.MethodsIn this Swedish population-based prospective study (the Malmö Preventive Project), the incidence of HF in relation to baseline OH, defined as decrease in systolic (SBP) >/=20 mm Hg and/or diastolic blood pressure (DBP) >/=10 mm Hg upon standing, was studied in 32,669 middle-aged individuals (68.2% men; mean age, 45.6 +/- 7.4 years) over a mean follow-up period of 24 years.ResultsAt baseline, 1,991 (6.1%) participants were found to have OH. During follow-up, 1,293 persons (4.0%, mean age at presentation: 67.9 +/- 7.9 years) were hospitalized for HF, 912 (2.8%) of whom without previous or concurrent myocardial infarction (MI) ("nonischemic HF"). Among those who had OH, the corresponding numbers were 6.5% (n = 129) and 4.6% (n = 92), respectively. In multivariable Cox proportional hazard models, taking conventional HF risk factors into account, OH was associated with both all-cause and "nonischemic" HF events (hazard ratio (HR): 1.22, 1.01-1.46, and 1.31, 1.05-1.63, respectively). The association between OH and HF was more pronounced in younger (aged <45 years) than older individuals (2.05; 1.31-3.22 vs. 1.12, 0.92-1.38, respectively, P < 0.001 for interaction between age and OH on incident HF).ConclusionsThe presence of OH among middle-aged adults predicts long-term incidence of HF hospitalizations independently of conventional risk factors. Our findings add to the available data indicating that OH is a potential independent cardiovascular risk factor, especially with regard to younger individuals and nonischemic HF.American Journal of Hypertension (2010). doi:10.1038/ajh.2010.150. (Less)
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published
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American Journal of Hypertension
volume
23
pages
1209 - 1215
publisher
Elsevier
external identifiers
  • wos:000283531900011
  • pmid:20651699
  • scopus:77958091095
ISSN
1941-7225
DOI
10.1038/ajh.2010.150
language
English
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yes
id
1f5cbedc-9d11-4ef3-beb3-bb59baba8ca3 (old id 1644626)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20651699?dopt=Abstract
date added to LUP
2010-08-05 09:55:23
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2017-01-01 07:48:38
@article{1f5cbedc-9d11-4ef3-beb3-bb59baba8ca3,
  abstract     = {BackgroundThe presence of orthostatic hypotension (OH) predicts all-cause mortality and incident cardiovascular disease. Whether or not OH is associated with the development of heart failure (HF) remains unknown.MethodsIn this Swedish population-based prospective study (the Malmö Preventive Project), the incidence of HF in relation to baseline OH, defined as decrease in systolic (SBP) &gt;/=20 mm Hg and/or diastolic blood pressure (DBP) &gt;/=10 mm Hg upon standing, was studied in 32,669 middle-aged individuals (68.2% men; mean age, 45.6 +/- 7.4 years) over a mean follow-up period of 24 years.ResultsAt baseline, 1,991 (6.1%) participants were found to have OH. During follow-up, 1,293 persons (4.0%, mean age at presentation: 67.9 +/- 7.9 years) were hospitalized for HF, 912 (2.8%) of whom without previous or concurrent myocardial infarction (MI) ("nonischemic HF"). Among those who had OH, the corresponding numbers were 6.5% (n = 129) and 4.6% (n = 92), respectively. In multivariable Cox proportional hazard models, taking conventional HF risk factors into account, OH was associated with both all-cause and "nonischemic" HF events (hazard ratio (HR): 1.22, 1.01-1.46, and 1.31, 1.05-1.63, respectively). The association between OH and HF was more pronounced in younger (aged &lt;45 years) than older individuals (2.05; 1.31-3.22 vs. 1.12, 0.92-1.38, respectively, P &lt; 0.001 for interaction between age and OH on incident HF).ConclusionsThe presence of OH among middle-aged adults predicts long-term incidence of HF hospitalizations independently of conventional risk factors. Our findings add to the available data indicating that OH is a potential independent cardiovascular risk factor, especially with regard to younger individuals and nonischemic HF.American Journal of Hypertension (2010). doi:10.1038/ajh.2010.150.},
  author       = {Fedorowski, Artur and Engström, Gunnar and Hedblad, Bo and Melander, Olle},
  issn         = {1941-7225},
  language     = {eng},
  pages        = {1209--1215},
  publisher    = {Elsevier},
  series       = {American Journal of Hypertension},
  title        = {Orthostatic Hypotension Predicts Incidence of Heart Failure: The Malmö Preventive Project.},
  url          = {http://dx.doi.org/10.1038/ajh.2010.150},
  volume       = {23},
  year         = {2010},
}