Mij
Senior Member (Voting Rights)
Objective:
Orthostatic hypotension (OH) is recognized as a poor prognostic factor, but its blood pressure (BP) phenotypes remain poorly understood. This study aimed to investigate the BP phenotypes associated with OH.
Design and method:
This study included 306 patients who underwent a head-up tilt test (HUT) and ambulatory blood pressure monitoring (ABPM) for typical OH symptoms. OH was defined as a decrease in systolic BP of at least 20 mmHg in normotensive individuals or at least 30 mmHg in patients with supine hypertension within 3 minutes of HUT. BP phenotypes were categorized as follows: normal BP patterns vs. abnormal BP patterns [white coat hypertension (WCH: elevated office BP with normal ambulatory BP during awake hours), masked hypertension (MH: elevated ABPM but not office BP), and sustained hypertension (elevated office BP and ABPM)]. Dipping patterns were classified as dipper, nondipper, reverse dipper, and extreme dipper.
Results:
The study population consisted of 306 patients, including 202 (66%) in the OH-positive group and 104 (34%) in the OH-negative group. The proportion of females was 70.3% (n=176), and the mean age was significantly higher in the OH-positive group compared to the OH-negative group (57 ± 17.9 vs. 48 ± 17.0 years). The proportion of patients receiving antihypertensive medication was also significantly higher in the OH-positive group (66% vs. 34%, p=0.001). The OH group showed a higher prevalence of abnormal BP patterns including WCH, MH, sustained hypertension, [(WCH (7.7% vs 8.9%), MH (9.6% vs 18.3%), sustained hypertension (2.9% vs 7.4%) in OH negative vs OH positive group], respectively, p=0.047], but no significant differences were observed in dipping patterns (p=0.233).
Conclusions:
Orthostatic hypotension is associated with abnormal BP patterns which might lead to poor prognosis, emphasizing the importance of evaluating BP phenotypes in these patients.
LINK
Orthostatic hypotension (OH) is recognized as a poor prognostic factor, but its blood pressure (BP) phenotypes remain poorly understood. This study aimed to investigate the BP phenotypes associated with OH.
Design and method:
This study included 306 patients who underwent a head-up tilt test (HUT) and ambulatory blood pressure monitoring (ABPM) for typical OH symptoms. OH was defined as a decrease in systolic BP of at least 20 mmHg in normotensive individuals or at least 30 mmHg in patients with supine hypertension within 3 minutes of HUT. BP phenotypes were categorized as follows: normal BP patterns vs. abnormal BP patterns [white coat hypertension (WCH: elevated office BP with normal ambulatory BP during awake hours), masked hypertension (MH: elevated ABPM but not office BP), and sustained hypertension (elevated office BP and ABPM)]. Dipping patterns were classified as dipper, nondipper, reverse dipper, and extreme dipper.
Results:
The study population consisted of 306 patients, including 202 (66%) in the OH-positive group and 104 (34%) in the OH-negative group. The proportion of females was 70.3% (n=176), and the mean age was significantly higher in the OH-positive group compared to the OH-negative group (57 ± 17.9 vs. 48 ± 17.0 years). The proportion of patients receiving antihypertensive medication was also significantly higher in the OH-positive group (66% vs. 34%, p=0.001). The OH group showed a higher prevalence of abnormal BP patterns including WCH, MH, sustained hypertension, [(WCH (7.7% vs 8.9%), MH (9.6% vs 18.3%), sustained hypertension (2.9% vs 7.4%) in OH negative vs OH positive group], respectively, p=0.047], but no significant differences were observed in dipping patterns (p=0.233).
Conclusions:
Orthostatic hypotension is associated with abnormal BP patterns which might lead to poor prognosis, emphasizing the importance of evaluating BP phenotypes in these patients.
LINK