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19-03-2012 | Article

Sudden BP drop ‘heart failure risk’

Abstract

Hypertension 2012; Advance online publication

People with orthostatic (postural) hypotension may have an increased risk of heart failure, research indicates.

The association seems stronger among people aged in their mid-forties to mid-fifties than in older people, report Dr Christine DeLong Jones (University of North Carolina at Chapel Hill, USA) and colleagues in Hypertension.

The researchers followed-up more than 12,000 patients aged 45-64 years for 17.5 years. They found that 11% of participants who developed heart failure had orthostatic hypotension at baseline - defined as a 20-mmHg fall in systolic or a 10-mmHg fall in diastolic blood pressure upon standing up from a lying-down position. This compared with 4% of participants who did not go on to develop heart failure.

Indeed, participants with orthostatic hypotension were 1.5 times as likely to develop heart failure as those without it. This rose to 1.9 times among participants aged 55 years or under.

The association was similar after excluding patients with diabetes or heart disease, and those on antihypertensives or psychiatric or Parkinson disease medications.

However, the overall risk was attenuated somewhat after excluding participants with hypertension, to 1.3 times that of people without orthostatic hypotension, suggesting that the association may be at least partly mediated by hypertension.

"Orthostatic blood pressure measurement may supplement what is already known about the risk for heart failure and requires no additional equipment, just a standard blood pressure cuff," said Dr Jones.

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price