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Orthostatic Hypotension Linked to Incident Heart Failure

Association stronger in those aged 55 or younger; attenuated by exclusion of those with hypertension

MONDAY, March 19 (HealthDay News) -- Orthostatic hypotension is associated with incident heart failure, and the association is stronger for those aged 55 years or younger and is slightly reduced by exclusion of individuals with hypertension, according to a study published online March 19 in Hypertension.

Christine D. Jones, M.D., from the University of North Carolina at Chapel Hill, and colleagues explored the association between orthostatic hypotension and heart failure in 12,363 adults free of prevalent heart failure from the Atherosclerosis Risk in Communities Study.

During 17.5 years of follow-up, the researchers found that orthostatic hypotension was significantly associated with incident heart failure in multivariable analysis (hazard ratio [HR], 1.54). The correlation was similar across races and genders and was stronger in individuals aged 55 or younger (HR for ≤55 years, 1.90; HR for >55 years, 1.37). The association persisted even when individuals with diabetes, coronary heart disease, and those on antihypertensives or psychiatric or Parkinson's medication were excluded. The association was reduced slightly by exclusion of those with hypertension (HR, 1.34).

"Implications from our study are that orthostatic hypotension appears to be associated with incident heart failure, which is somewhat attenuated with the exclusion of participants with hypertension," the authors write. "Given our findings, we speculate that orthostatic hypotension preceding heart failure may be a marker of early subclinical atherosclerosis that is facilitated by hypertension and potentially by other risk factors to contribute to heart failure development."

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