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Is orthostatic hypotension more common in individuals with atrial fibrillation?-Findings from The Irish Longitudinal

T McNicholas1,2, K Tobin1,3, S O'Callaghan1,4

  • 1The Irish Longitudinal Study on Ageing, Lincoln gate, Trinity College Dublin, Dublin, Ireland.

Age and Ageing
|October 7, 2017
PubMed

Insights

Individuals with atrial fibrillation (AF) are more likely to experience orthostatic hypotension (OH). This association may be linked to the autonomic nervous system

Area of Science:

  • Cardiology
  • Gerontology
  • Autonomic Neuroscience

Background:

  • Atrial fibrillation (AF) and orthostatic hypotension (OH) share risk factors like age, hypertension, and cardiovascular disease.
  • The autonomic nervous system (ANS) is implicated in the development of both AF and OH.

Purpose of the Study:

  • To investigate the association between atrial fibrillation (AF) and the likelihood of experiencing orthostatic hypotension (OH).

Main Methods:

  • Utilized data from The Irish Longitudinal Study on Ageing (TILDA) wave 1.
  • Measured beat-to-beat blood pressure during a 110-second active stand test in 4,408 participants (≥50 years).
  • Defined OH as a significant drop in systolic blood pressure (SBP) ≥20 mmHg or diastolic blood pressure (DBP) ≥10 mmHg; Initial OH (IOH) defined as SBP drop ≥40 mmHg or DBP drop ≥20 mmHg.

Main Results:

  • Participants with AF (n=101) showed a higher likelihood of OH at 30 seconds (OR 1.95) and 60 seconds (OR 2.13).
  • A greater likelihood of Initial OH (IOH) was observed in individuals with AF (OR 1.81).
  • The association between IOH and OH at 30 seconds remained significant after adjusting for multiple confounders.

Conclusions:

  • Orthostatic hypotension (OH) is more prevalent in individuals diagnosed with atrial fibrillation (AF).
  • The findings suggest a potential role for the autonomic nervous system (ANS) in the co-occurrence of AF and OH.
Abstract

Keywords:
Older peopleatrial fibrillationfallsorthostatic hypotensionsyncope

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