PREVALENCE AND CORRELATES OF ORTHOSTATIC HYPOTENSION IN A COHORT OF HYPERTENSIVE PATIENTS: PP.19.258

Abstract

Objective: The aim of our study was to determine the prevalence and clinical correlates of OH in a wide cohort of hypertensive patients. Design and Method: We performed a cross-sectional study on 9571 patients (age 53 ± 14, 48% males) attending our hypertension unit from 1989 to 2008. OH was defined as a decrease in blood pressure (BP) of at least 20 mmHg systolic and/or 10 mmHg diastolic within 3 min of standing up. Results: The prevalence of OH was 3.2%. OH was associated with increasing age, higher supine BP values and degree of hypertension, the use of ACE-inhibitors, diuretics, calcium antagonists, alpha-blockers and centrally-acting drugs (p < 0.005). OH was more represented in those patients taking an increasing number of antihypertensive drugs (three or more drugs in 28% of patients with and 17% without OH, p < 0.0001). The use of angiotensin receptor blockers was not associated with OH (p = 0.0013). Age (OR 1.019, 95%CI 1.008–1.031, p = 0.001), systolic BP (OR 1.031, 95%CI 1.024–1.038, p = 0.0001), and alpha-blockers (OR 1.775, 95%CI 1.282–2.456, p = 0.0005) predicted OH, and angiotensin receptor blockers (OR 0.322, 95%CI 0.175–0.594, p = 0.0003) protected from OH in the logistic multivariate regression analysis. Conclusions: Age, severe and uncontrolled hypertension, and the use of alpha-blockers predict the development of OH in hypertensive patients. Due to OH adverse severe consequences, hypertension should be treated judiciously and OH should be routinely detected and treated in the hypertension clinic.