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The association of postural changes in systolic blood pressure and mortality in persons with hypertension: the

B R Davis, H G Langford, M D Blaufox

    Circulation
    |February 1, 1987
    PubMed

    Insights

    Postural hypotension, a drop in blood pressure upon standing, is linked to higher mortality in hypertensive individuals. This risk is particularly pronounced in diabetic patients, suggesting a poor prognosis.

    Area of Science:

    • Cardiology
    • Gerontology
    • Public Health

    Background:

    • Postural hypotension is a common condition, especially in older adults.
    • Understanding its association with mortality is crucial for clinical practice.

    Purpose of the Study:

    • To investigate the relationship between postural systolic blood pressure changes and 5-year mortality in hypertensive patients.
    • To identify potential confounding factors and interactions influencing this association.

    Main Methods:

    • Classified participants of the Hypertension Detection and Follow-up Program (HDFP) into four groups based on postural systolic blood pressure drop.
    • Utilized a multiple logistic model to adjust for various baseline risk factors.
    • Examined interactions between postural changes and risk factors like diabetes and relative weight.

    Main Results:

    • Significant differences in 5-year mortality rates were observed across the postural blood pressure groups (p < .04).
    • Group 1, characterized by significant postural hypotension (≥ -20 mm Hg drop), exhibited the highest mortality rates.
    • Relative weight was identified as a confounding factor, while an interaction between diabetes history and postural blood pressure change was noted.

    Conclusions:

    • Postural hypotension is associated with increased 5-year mortality in hypertensive patients.
    • The prognostic significance of postural hypotension is amplified in hypertensive individuals with a history of diabetes.
    • These findings highlight the importance of assessing postural blood pressure in hypertensive patients, especially those with diabetes.

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