Online citations, reference lists, and bibliographies.

Orthostatic Hypotension As A Risk Factor For Stroke: The Atherosclerosis Risk In Communities (ARIC) Study, 1987–1996

Marsha L. Eigenbrodt, Kathryn M. Rose, David Couper, Donna K Arnett, Robert Nelson Smith, D. H. P. Jones
Published 2000 · Medicine
Cite This
Download PDF
Analyze on Scholarcy
Share
Background and Purpose The association between orthostatic hypotension (OH) and stroke has rarely been investigated in longitudinal studies. The purpose of the present study was to determine whether OH predicts ischemic stroke in a middle-aged, biethnic population after adjustment for known stroke risk factors. Diastolic, systolic, and consensus OH were evaluated for baseline associations and for the ability to predict stroke. Methods In 11 707 persons from the Atherosclerosis Risk in Communities (ARIC) cohort who were free of stroke and overt heart disease at baseline, Cox proportional hazards analyses modeled the association between OH at baseline and incident ischemic stroke over 7.9 years of follow-up. OH was defined as a systolic blood pressure drop ≥20 mm Hg (systolic OH), a diastolic blood pressure drop ≥10 mm Hg (diastolic OH), or a drop in either (consensus OH) when a person changed from a supine to standing position. Results OH was predictive of ischemic stroke, even after adjustment for numerous stroke risk factors (consensus OH: hazard ratio, 2.0; 95% CI, 1.2 to 3.2). While the baseline characteristics associated with OH varied depending on the type of OH, all types of OH had a similar risk of stroke. Conclusions OH is an easily obtained measurement that may help to identify middle-aged persons at risk for stroke.
This paper references
10.1111/j.1532-5415.1989.tb02641.x
Effect of timing and number of baseline blood pressure determinations on postural blood pressure response.
Scott L. Mader (1989)
10.1016/S0002-9343(97)89517-4
Reproducibility of orthostatic hypotension in symptomatic elderly.
Chris R. Ward (1996)
10.1007/BF02291236
Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy
Horacio Kaufmann (1996)
10.1042/cs0670321
Mechanisms of initial blood pressure response to postural change.
Cornelius Borst (1984)
10.1016/S0002-9149(99)80769-3
Relation between electrocardiography and echocardiography for left ventricular mass in mild systemic hypertension (results from Treatment of Mild Hypertension Study).
Richard S. Crow (1995)
10.1111/j.1532-5415.1991.tb02869.x
Prevalence of postural hypotension at baseline in the Systolic Hypertension in the Elderly Program (SHEP) cohort.
William B. Applegate (1991)
Maladaptation of vascular response in frontal area of patients with orthostatic hypotension.
Kyoko Hayashida (1996)
The Bergen Blood Pressure Study. Estimated prevalence of postural hypotension is influenced by the alerting reaction to blood pressure measurement.
Rune Mo (1994)
10.1161/01.HYP.19.6.508
Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group.
Gale H. Rutan (1992)
10.1056/NEJM198708273170901
Analysis of risk factors for stroke in a cohort of men born in 1913.
L. Welin (1987)
10.1161/01.CIR.70.4.533
Postural changes in diastolic blood pressure and the risk of myocardial infarction: the Normative Aging Study.
David Sparrow (1984)
Orthostatic hypotension in older adults: the Cardiovascular Health Study. Hypertension
GH Rutan (1992)
Orthostatic hypotension: causes, mechanisms, and influencing factors.
Christopher J. Mathias (1995)
10.1161/01.STR.27.9.1479
Short-term predictors of incident stroke in older adults. The Cardiovascular Health Study.
Teri A Manolio (1996)
10.1111/j.1532-5415.1990.tb03469.x
Reduced supine cardiac volumes and diastolic filling rates in elderly patients with chronic medical conditions. Implications for postural blood pressure homeostasis.
Lewis Lipsitz (1990)
10.1161/01.STR.27.4.672
Risk factors for death from stroke in middle-aged Lithuanian men: results from a 20-year prospective study.
Daiva Rastenytė (1996)
The epidemiology of stroke.
John Grimley Evans (1979)
Blood Pressure as a Cardiovascular Risk Factor
William B. Kannel (1997)
10.1001/jama.1997.03540400049030
Patterns of orthostatic blood pressure change and their clinical correlates in a frail, elderly population.
Wee Lock Ooi (1997)
10.1093/ajcn/36.5.936
A short questionnaire for the measurement of habitual physical activity in epidemiological studies.
J A Baecke (1982)
10.1212/WNL.47.6.1420
A population-based model of risk factors for ischemic stroke
Jack P. Whisnant (1996)
10.1161/01.HYP.34.6.1181
J-shaped relation between blood pressure and stroke in treated hypertensives.
Zoltán Vokó (1999)
10.1161/01.STR.30.4.736
Stroke incidence and survival among middle-aged adults: 9-year follow-up of the Atherosclerosis Risk in Communities (ARIC) cohort.
Wayne D. Rosamond (1999)
10.1161/01.CIR.75.2.340
The association of postural changes in systolic blood pressure and mortality in persons with hypertension: the Hypertension Detection and Follow-up Program experience.
Barry R. Davis (1987)
10.1093/oxfordjournals.aje.a010233
Carotid wall thickness is predictive of incident clinical stroke: the Atherosclerosis Risk in Communities (ARIC) study.
Lloyd Chambless (2000)
10.1001/archinte.159.12.1350
Postural hypotension and postural dizziness in patients with non-insulin-dependent diabetes.
J S Wu (1999)
10.1161/01.CIR.98.21.2290
Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program.
Kamal H. Masaki (1998)
10.1001/jama.1970.03180020021004
Epidemiologic assessment of the role of blood pressure in stroke. The Framingham study.
William B. Kannel (1970)
10.1097/00008483-199205000-00014
Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group.
(1991)
Hypotensive reactions on passive head-up tilt testing of hypertensive patients.
E Naschitz (1996)
10.1016/1047-2797(93)90103-B
Risk factors for death from different types of stroke
James D. Neaton (1993)
10.1016/0002-9343(91)90012-M
Syncope and orthostatic hypotension.
David A. Atkins (1991)
10.1161/01.STR.31.2.420
Control of blood pressure and risk of stroke among pharmacologically treated hypertensive patients.
Olaf H Klungel (2000)
10.1161/01.STR.12.3.353
Transient Ischemic Attacks Associated with Hypotension in Hypertensive Patients with Carotid Artery Stenosis
Robert L. Ruff (1981)
Orthostatic hypotension. Causes, evaluation, and management.
Alan S. Hollister (1992)
Orthostatic hypotension and the incidence of coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) Study
K Rose (2000)
10.1093/oxfordjournals.eurheartj.a060143
Prevalence and variability of orthostatic hypotension in the elderly. Results of the 'Italian study on blood pressure in the elderly (SPAA)'. The 'Gruppo di Studio Sulla Pressione Arteriosa nell'Anziano'.
Claudio Alli (1992)
10.1093/clinchem/18.6.499
Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.
William T. Friedewald (1972)
10.1001/archinte.1995.00430090067008
Prevalence, predisposing factors, and prognostic importance of postural hypotension.
Ismo Räihä (1995)
Syncope and orthostatic hypotension.Am
D Atkins (1991)
10.1212/WNL.39.1.30
Orthostatic hypotension as a risk factor for symptomatic occlusive cerebrovascular disease
Bruce H Dobkin (1989)
10.1161/01.CIR.96.2.701
American Heart Association Prevention Conference IV: prevention and rehabilitation of stroke: executive summary.
Cathy M. Helgason (1997)
10.1016/S0895-7061(96)00505-5
Is diastolic hypertension an independent risk factor for stroke in the presence of normal systolic blood pressure in the middle-aged and elderly?
W B Nielsen (1997)
10.1001/jama.1987.03400130096040
Senile dementia of the Binswanger type. A vascular form of dementia in the elderly.
Gustavo C. Román (1987)
10.1111/jon199114168
High-resolution B-mode ultrasound reading methods in the Atherosclerosis Risk in Communities (ARIC) cohort. The ARIC Study Group.
Ward A. Riley (1991)
10.1093/oxfordjournals.aje.a115184
The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators.
Moysés Szklo (1989)
10.1161/01.CIR.90.1.298
Cerebral Versus Systemic Hemodynamics During Graded Orthostatic Stress in Humans
B. D. Levine (1994)
10.1161/01.HYP.33.5.1123
Descriptive epidemiology of blood pressure response to change in body position. The ARIC study.
Christopher J. Nardo (1999)
10.1055/s-0038-1646519
ARIC hemostasis study--I. Development of a blood collection and processing system suitable for multicenter hemostatic studies.
A C Papp (1989)
Orthostatic hypotension.
R C Ziss (1957)
10.1002/j.1552-4604.1994.tb04977.x
Hemodynamic response to the upright posture.
Joshua J Smith (1994)
10.1001/jama.1987.03400110093033
Low prevalence of postural hypotension among community-dwelling elderly.
Scott L. Mader (1987)
10.1093/oxfordjournals.aje.a009445
Stroke incidence among white, black, and Hispanic residents of an urban community: the Northern Manhattan Stroke Study.
Ralph L. Sacco (1998)
10.1161/01.CIR.88.5.2471
Lewis A. Conner Lecture. Contributions of epidemiology to the prevention of stroke.
Philip A. Wolf (1993)
10.1002/j.1552-4604.1994.tb04979.x
Cardiovascular responses to postural changes: differences with age for women and men.
Mary Anne Bassett Frey (1994)
10.1001/archinte.1984.00350160129021
Orthostatic hypotension. I. Functional and neurogenic causes.
Irwin J. Schatz (1984)
[Orthostatic hypotension in the elderly].
Jan den Boon (1990)
Control of blood pressure and risk of stroke among pharmacologically treated hypertensive patients.Stroke
OH Klungel (2000)



This paper is referenced by
10.1002/mdc3.12726
Six‐Month Use of Droxidopa for Neurogenic Orthostatic Hypotension
Clément François (2019)
10.2217/FNL.13.28
L-DOPS and the treatment of neurogenic orthostatic hypotension
Ekawat Vichayanrat (2013)
10.1111/joim.12021
Syndromes of orthostatic intolerance: a hidden danger.
Artur Fedorowski (2013)
10.3109/15622975.2010.488273
The safety and tolerability of clozapine in aged patients: A retrospective clinical file review
Daniel W O'Connor (2010)
Do abnormalities in dynamic cerebral auto-regulation underlie the pathophysiological processes behind syncope in older people?
Alice C. L. Ong (2014)
The effect of gender and physical capacity on cardiovascular control in the elderly
Vanessa Castellano (2002)
10.1016/J.LPM.2012.03.025
Hypotension orthostatique : quelles explorations cardiovasculaires et biologiques initiales ? Quelles solutions thérapeutiques ? L’apport des recommandations
Claude Kouakam (2012)
10.1155/2012/908431
Hypertension: From Epidemiology to Therapeutics
Manuel Velasco (2012)
10.1016/j.phymed.2014.06.014
The effects of repeated administration of camphor-crataegus berry extract combination on blood pressure and on attentional performance - a randomized, placebo-controlled, double-blind study.
Lg Erfurt (2014)
10.1002/mdc3.12286
Associations Between Cardiovascular Events and Nonergot Dopamine Agonists in Parkinson's Disease.
James A G Crispo (2016)
10.1007/s13760-019-01113-7
Nocturnal blood pressure changes in Parkinson’s disease: correlation with autonomic dysfunction and vitamin D levels
Ozge Arici Duz (2019)
10.1001/jama.2015.10082
Association Between Blood Pressure Control and Risk of Recurrent Intracerebral Hemorrhage.
A. Biffi (2015)
Mortality and prognosis in patients with neurogenic orthostatic hypotension.
Simona Maule (2012)
Orthostatic Hypotension as a marker of Frailty in Older People
Román Romero Ortuño (2011)
Recurrent Transient Ischemic Attacks Caused by Postprandial Hypotension in a Patient with Occlusion of Right Internal Carotid Artery
Jinkwon Kim (2006)
10.5580/1a4f
Alterations in Hemodynamic Profile in Orthostatic Hypotension
Sandeep Munjal (2004)
10.3390/brainsci9070162
Relationship between Ischemic Stroke and Pulse Rate Variability as a Surrogate of Heart Rate Variability
Ajay K. Verma (2019)
10.20996/1819-6446-2018-14-5-774-784
Arterial Hypertension in Older Adults in the Light of New European Guidelines 2018
O D Ostroumova (2018)
10.1097/HJH.0b013e328365cd59
Systolic and diastolic component of orthostatic hypotension and cardiovascular events in hypertensive patients: the Captopril Prevention Project
Artur Fedorowski (2014)
10.1002/mds.25179
Parkinson's disease and the risk of cerebrovascular pathology.
James F. Morley (2012)
10.1016/j.jamda.2013.10.014
Management of neurogenic orthostatic hypotension.
Debbie Arbique (2014)
10.1007/978-3-319-46293-6_14
Cardiovascular Dysfunction Following Spinal Cord Injury
A. Phillips (2017)
10.1291/hypres.27.235
Greater change of orthostatic blood pressure is related to silent cerebral infarct and cardiac overload in hypertensive subjects.
Kazuo Eguchi (2004)
10.1291/hypres.28.537
Orthostatic Systolic Hypotension and the Reflection Pressure Wave
Yasuharu Tabara (2005)
10.1097/00041433-200012000-00015
Hyperlipidaemia and cardiovascular disease.
Lewis H. Kuller (2000)
10.1111/jch.13613
Orthostatic hypotension and the risk of atrial fibrillation and other cardiovascular diseases: An updated meta-analysis of prospective cohort studies.
Min Min (2019)
10.1038/ajh.2010.150
Orthostatic hypotension predicts incidence of heart failure: the Malmö preventive project.
Artur Fedorowski (2010)
10.1038/nrneurol.2009.136
Parkinson disease and comorbid cerebrovascular disease
Wandana Nanhoe-Mahabier (2009)
10.1310/sci2301-11
Cardiovascular Physiology and Responses to Sexual Activity in Individuals Living with Spinal Cord Injury.
Ross A Davidson (2017)
10.1136/pgmj.2007.062075
Neurogenic orthostatic hypotension: chasing “the fall”
Dharmendra Lal Gupta (2008)
Meta-Analysis of Randomized Trials on the Efficacy and Safety of Angiotensin-Converting Enzyme Inhibitors in Patients 65Years of Age
Chirag P Bavishi ()
10.1186/s12933-016-0399-0
Diastolic orthostatic hypertension and cardiovascular prognosis in type 2 diabetes: a prospective cohort study
Magnus O Wijkman (2016)
See more
Semantic Scholar Logo Some data provided by SemanticScholar