Orthostatic hypotension and the risk of incidental cardiovascular diseases: A meta-analysis of prospective cohort studies.

Abstract

To quantitatively estimate the prospective associations between orthostatic hypotension (OH) and cardiovascular diseases, including coronary heart disease (CHD) and stroke. Relevant prospective cohort studies were identified by searching of Medline and Embase databases. We applied fixed or random effect model to estimate the overall effects depending on the heterogeneity among the included studies. Eight published articles from 7 cohorts, consisting of 64,782 participants, were included. During a mean follow-up of 15.2years, 5719 CHD events and 3657 stroke events occurred. The overall results of the meta-analysis indicated that OH was associated with significant increased risk for incident CHD (adjusted hazard ratio [HR]: 1.32, 95% confidence interval [CI]: 1.12-1.56) and stroke (HR: 1.19, 95% CI 1.08-1.30), which were independent of conventional risk factors. Stratified analyses by ages suggested that the associations between OH and CHD and stroke were significant for both the middle-aged and the old participants. Presence of OH was independently related to significantly increased risk for incidence of CHD and stroke. Further, studies regarding the mechanisms and potential treatments for OH may be important for understanding whether the associations between OH and cardiovascular diseases are causative.