Increased pulse wave velocity in patients with an orthostatic blood pressure rise independent of other cardiovascular risk factors
Nolde JM, Lugo-Gavidia LM, Kannenkeril D, Chan J, Matthews VB, Carnagarin R, Azzam O, Kiuchi MG, Schlaich MP (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 39
Pages Range: 1352-1360
Journal Issue: 7
DOI: 10.1097/HJH.0000000000002787
Abstract
BACKGROUND: Positional changes in blood pressure (BP) have been shown to have effects on long-term outcomes. Although a BP drop with upright posture is frequently observed, an orthostatic rise in BP can also occur. Here, we aimed to investigate whether the phenotype of orthostatic hypertension is associated with more pronounced vascular hypertension-mediated organ damage (HMOD) and whether this is associated with other cardiovascular risk factors. METHODS: In a cohort of 200 patients referred to our tertiary hypertension clinic, we prospectively assessed unattended seated automated office BP and the response to 1 min of upright posture. The difference in BP after standing up was calculated and pulse wave velocity (PWV) was assessed as a marker of vascular HMOD. Routine clinical cardiovascular risk markers were also assessed. Regression models were used to assess the association between orthostatic BP changes and pulse wave velocity. RESULTS: Baseline characteristics and clinic cardiovascular risk factors were similar between orthostatic BP response groups. A U-shaped association was evident between PWV and orthostatic BP changes with elevated PWV in patients with either a fall or a rise in BP in response to upright posture. The regression models remained significant after adjusting for other cardiovascular risk factors, including 24 h ambulatory BP. CONCLUSION: Both an orthostatic BP drop and rise were associated with elevated PWV. Although standing BP is commonly measured in elderly hypertensive patients to exclude significant orthostatic hypotension, this simple measurement may provide an additional independent risk factor for vascular HMOD at any age.
Involved external institutions
Australia (AU)How to cite
APA:
Nolde, J.M., Lugo-Gavidia, L.M., Kannenkeril, D., Chan, J., Matthews, V.B., Carnagarin, R.,... Schlaich, M.P. (2021). Increased pulse wave velocity in patients with an orthostatic blood pressure rise independent of other cardiovascular risk factors. Journal of Hypertension, 39(7), 1352-1360. https://doi.org/10.1097/HJH.0000000000002787
MLA:
Nolde, Janis M., et al. "Increased pulse wave velocity in patients with an orthostatic blood pressure rise independent of other cardiovascular risk factors." Journal of Hypertension 39.7 (2021): 1352-1360.
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