Orthostatic hypotension predicts mortality in middle-aged adults: The Atherosclerosis Risk in Communities (ARIC) Study

Kathryn M. Rose, Marsha L. Eigenbrodt, Rebecca L. Biga, David J. Couper, Kathleen C. Light, A. Richey Sharrett, Gerardo Heiss

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Abstract

BACKGROUND - An association between orthostatic hypotension (OH) and mortality has been reported, but studies are limited to older adults or high-risk populations. METHODS AND RESULTS - We investigated the association between OH (a decrease of 20 mm Hg in systolic blood pressure or a decrease of 10 mm Hg in diastolic blood pressure on standing) and 13-year mortality among middle-aged black and white men and women from the Atherosclerosis Risk in Communities Study (1987-1989). At baseline, 674 participants (5%) had OH. All-cause mortality was higher among those with (13.7%) than without (4.2%) OH. After we controlled for ethnicity, gender, and age, the hazard ratio (HR) for OH for all-cause mortality was 2.4 (95% confidence interval [CI], 2.1 to 2.8). Adjustment for risk factors for cardiovascular disease and mortality and selected health conditions at baseline attenuated but did not completely explain this association (HR=1.7; 95% CI, 1.4 to 2.0). This association persisted among subsets that (1) excluded those who died within the first 2 years of follow-up and (2) were limited to those without coronary heart disease, cancer, stroke, diabetes, hypertension, or fair/poor perceived health status at baseline. In analyses by causes of death, a significant increased hazard of death among those with versus without OH persisted after adjustment for risk factors for cardiovascular disease (HR=2.0; 95% CI, 1.6 to 2.7) and other deaths (HR=2.1; 95% CI, 1.6 to 2.8) but not for cancer (odds ratio=1.1; 95% CI, 0.8 to 1.6). CONCLUSIONS - OH predicts mortality in middle-aged adults. This association is only partly explained by traditional risk factors for cardiovascular disease and overall mortality.

Original languageEnglish (US)
Pages (from-to)630-636
Number of pages7
JournalCirculation
Volume114
Issue number7
DOIs
StatePublished - Aug 1 2006

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Keywords

  • Cardiovascular diseases
  • Hypotension
  • Middle aged
  • Mortality
  • Orthostatic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Rose, K. M., Eigenbrodt, M. L., Biga, R. L., Couper, D. J., Light, K. C., Sharrett, A. R., & Heiss, G. (2006). Orthostatic hypotension predicts mortality in middle-aged adults: The Atherosclerosis Risk in Communities (ARIC) Study. Circulation, 114(7), 630-636. https://doi.org/10.1161/CIRCULATIONAHA.105.598722