An Emerging Role for Understanding Orthostatic Hyp'er'tension in the Cardiorenal Syndrome

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Jaya P Buddineni, Laxmi Chauhan, Syed T Ahsan

    Cardiorenal Medicine
    |January 20, 2012
    PubMed

    Insights

    Orthostatic hypertension (OHT) is a growing concern, linked to increased risks of heart and kidney disease. Further research is needed to understand its full impact on cardiovascular disease and chronic kidney disease progression.

    Area of Science:

    • Cardiology
    • Nephrology
    • Endocrinology

    Background:

    • Orthostatic hypertension (OHT) is increasingly recognized in patients with borderline hypertension, diabetes, autonomic dysfunction, and the elderly.
    • OHT is associated with accelerated end-organ damage, particularly coronary heart disease (CHD) and chronic kidney disease (CKD).
    • The heightened risk of cardiovascular disease (CVD) and CKD associated with OHT is underappreciated.

    Purpose of the Study:

    • To review the clinical significance of OHT.
    • To explore the association between OHT and the progression of CKD and CVD.
    • To discuss the underlying mechanisms contributing to OHT and cardiorenal metabolic disease (CRS).

    Main Methods:

    • Literature review of existing studies on OHT, CKD, and CVD.
    • Analysis of pathophysiological mechanisms linking OHT to cardiorenal outcomes.
    • Synthesis of evidence regarding the clinical impact and risk stratification associated with OHT.

    Main Results:

    • OHT is linked to significant end-organ damage, including CKD and CHD.
    • Mechanisms such as adrenergic sensitivity, baroreceptor dysfunction, and renin-angiotensin-aldosterone system activation contribute to OHT and CRS.
    • Evidence suggests OHT is an independent risk factor for cardiorenal metabolic disease.

    Conclusions:

    • OHT poses a significant clinical challenge with underappreciated risks for CKD and CVD.
    • Understanding the mechanisms of OHT is crucial for managing patients at risk of cardiorenal metabolic disease.
    • Further clinical investigation is warranted to fully elucidate the impact of OHT on CKD and CVD progression.

    Keywords:
    Cardiovascular diseaseChronic kidney diseaseHypertensionOrthostatic blood pressure

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