Impact of Variations in Blood Pressure with Orthostatism on Mortality: the Homo Study

ObjectiveThe aim of this study was to determine the impact of orthostatic hypotension (OH) and orthostatic hypertension (OHT) on all-cause mortality.Patients and methodsA total of, 1176 adults from the community over 18 years of age were included in this ambispective study. The mean follow-up was 9.4 years. OH and OHT were defined as a decrease or an increase, respectively, in systolic blood pressure (BP) of at least 20mmHg and/or diastolic BP of at least 10mmHg from sitting to standing position at 1 and/or 3min after standing. The impact of systolic or diastolic OH and systolic or diastolic OHT at 1 and 3min after standing was also analyzed separately.ResultsIn total, 135 individuals died during the follow-up. Neither OH [hazard ratio (HR) 1.23; 95% confidence interval (CI): 0.72-2.10] nor OHT (HR 0.90; 95% CI: 0.59-1.38) was associated with all-cause mortality in the adjusted models. In contrast, systolic OHT at 3min (HR 2.31; 95% CI: 1.14-4.68) was independently associated with global mortality.ConclusionSystolic OHT at 3min is associated with all-cause mortality. The determination of this parameter could add valuable prognostic information during the routine examination of patients.