Treating Hypertension in Patients With Orthostatic Hypotension

28 Oct 2023 • Does the effect of intensive blood pressure treatment on CVD or all-cause mortality differ based on the presence or absence of orthostatic or standing hypotension? A meta-analysis published in JAMA provides reassurance that neither type of hypotension should deter from adopting more-intensive blood pressure management in patients with hypertension.

  • In this individual data meta-analysis of more than 29 000 participants in 9 hypertension trials, more intensive blood pressure treatment lowered risk of cardiovascular disease or all-cause mortality regardless of whether participants had orthostatic hypotension. Moreover, effects did not differ by the presence or absence of standing hypotension.

In conclusion, people with orthostatic hypotension or standing hypotension had a higher risk for adverse outcomes, but they experienced relative risk reductions in response to intensification of BP management that were not significantly different from those without these conditions. Asymptomatic orthostatic hypotension or standing hypotension among adults with hypertension should not be a deterrent to more intensive hypertension treatment.

Source: NEJM J-Watch | Read full story

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