Abstract
We examined the association of orthostatic hypertension with all-cause mortality in the active treatment and placebo randomized groups of the Systolic Hypertension in the Elderly Program (SHEP). SHEP was a multicenter, randomized, double-blind, placebo-controlled clinical trial of the effect of chlorthalidone-based antihypertensive treatment on the rate of occurrence of stroke among older persons with isolated systolic hypertension (ISH). Men and women aged 60 years and above with ISH defined by a systolic blood pressure (SBP) of 160 mm Hg or higher and diastolic blood pressure lower than 90 mm Hg were randomized to chlorthalidone-based stepped care therapy or matching placebo. Among 4736 SHEP participants, 4073 had a normal orthostatic response, 203 had orthostatic hypertension, and 438 had orthostatic hypotension. Compared with normal response, orthostatic hypertension was associated with higher all-cause mortality at 4.5 and 17 years in analyses adjusted for age, gender, treatment, SBP, and pulse pressure (PP, HR 1.87, 95% CI 1.30-2.69, p = 0.0007; HR 1.40, 95% CI 1.17-1.68, p = 0.0003, respectively). These associations remained significant after additional adjustment for risk factors and comorbidities (HR 1.43, 95% CI 0.99-...Continue Reading
References
Feb 1, 1987·Circulation·B R DavisN B Shulman
Mar 1, 1985·Hypertension·D H StreetenJ W Miller
Oct 1, 1984·Circulation·D SparrowS T Weiss
Jul 1, 1996·Hypertension·N L BenowitzM Cheitlin
Nov 22, 1997·Stroke; a Journal of Cerebral Circulation·K MatsubayashiT Ozawa
Feb 4, 1998·Hypertension·K KarioK Shimada
Nov 24, 1998·Circulation·K H MasakiJ D Curb
May 20, 1999·Hypertension·C J NardoG Heiss
Apr 19, 2000·Hypertension Research : Official Journal of the Japanese Society of Hypertension·A MoriguchiT Ogihara
Sep 28, 2001·Diabetes Care·M YoshinariM Iwase
Jul 10, 2002·Journal of the American College of Cardiology·Kazuomi KarioKazuyuki Shimada
May 7, 2004·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Kazuo EguchiKazuyuki Shimada
Jul 9, 2004·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·A Diedrich, I Biaggioni
Jun 23, 2005·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Satoshi HoshideKazuyuki Shimada
Apr 17, 2008·Journal of Diabetes and Its Complications·Flavio E HiraiRonald Klein
Apr 29, 2011·Journal of the American College of Cardiology·Wilbert S AronowDeborah J Wesley
Dec 22, 2011·JAMA : the Journal of the American Medical Association·John B KostisBarry R Davis
Jan 14, 2012·Journal of Hypertension·Artur FedorowskiOlle Melander
Apr 17, 2012·European Heart Journal·Artur FedorowskiOlle Melander
Jun 1, 2012·Hypertension·Ehud GrossmanAvshalom Leibowitz
Jun 25, 2013·American Journal of Otolaryngology·Eun-Ju JeonKi-Hong Chang
Sep 26, 2013·Journal of Hypertension·Artur FedorowskiOlle Melander
Oct 8, 2013·Handbook of Clinical Neurology·Horacio Kaufmann, David S Goldstein
Nov 6, 2013·Nature Reviews. Nephrology·Kazuomi Kario
Mar 19, 2014·Journal of the American Society of Hypertension : JASH·Jingsong XuHai Su
Mar 15, 2015·American Journal of Hypertension·Nicola VeroneseGiuseppe Sergi
Aug 14, 2015·Journal of the American College of Cardiology·Fabrizio RicciArtur Fedorowski
Sep 27, 2016·Journal of the American Society of Hypertension : JASH·Raymond R TownsendUNKNOWN SPRINT Study Research Group
Mar 7, 2017·Blood Pressure Monitoring·Sonsoles M Velilla-ZancadaLuis A Vara-Gonzalez
Mar 8, 2017·Hypertension·Alyssa TorjesenGary F Mitchell
May 31, 2017·Annales de cardiologie et d'angéiologie·W N Nibouche-HattabA Biad
Sep 21, 2017·The Journal of Clinical Hypertension·Rachael V TorresAdam Davey
Jul 28, 2018·European Heart Journal·Ruth PetersChristopher J Bulpitt
Sep 8, 2018·Journal of the American College of Cardiology·Roy FreemanDong In Sinn
Citations
Jul 18, 2020·Blood Pressure Monitoring·Suleyman Emre KocyigitAhmet Turan Isik
Jan 28, 2020·Hypertension·Stephen P JuraschekUNKNOWN SPRINT Research Group
Apr 1, 2020·Hypertension·Jens JordanArtur Fedorowski
Sep 16, 2020·Palliative & Supportive Care·Annina SeilerSoenke Boettger
Nov 10, 2020·Hypertension·Mahboob RahmanJackson T Wright