Standing Blood Pressure and Risk of Falls, Syncope, Coronary Heart Disease, and Mortality.

Autor:	Kondo JK; Harvard Medical School, Boston, Massachusetts, USA., Earle WB; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Turkson-Ocran RN; Harvard Medical School, Boston, Massachusetts, USA.; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Ngo LH; Harvard Medical School, Boston, Massachusetts, USA.; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Cluett JL; Harvard Medical School, Boston, Massachusetts, USA.; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Lipsitz LA; Harvard Medical School, Boston, Massachusetts, USA.; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.; Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts, USA., Daya NR; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Selvin E; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Lutsey PL; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA., Coresh J; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Windham BG; Department of Medicine, Division of Geriatric Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA., Kendrick KN; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.; Department of Medicine, Winchester Hospital, Beth Israel Lahey Health, Woburn, MA, USA., Juraschek SP; Harvard Medical School, Boston, Massachusetts, USA.; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	American journal of hypertension [Am J Hypertens] 2023 Oct 13; Vol. 36 (11), pp. 593-601.
DOI:	10.1093/ajh/hpad064
Abstrakt:	Background: ACC/AHA guidelines caution against the use of antihypertensive therapy in the setting of low standing systolic BP (SBP) < 110 mm Hg due to unclear benefits. Methods: The Atherosclerosis Risk in Communities (ARIC) Study measured supine and standing SBP in adults aged 45-64 years between 1987 and 1989. We used Cox regression to evaluate the associations of low standing SBP (<110 mm Hg) with risk of falls, syncope, coronary heart disease (CHD), and mortality through December 31, 2019. Falls and syncope were ascertained by hospitalization and outpatient claims; CHD events were adjudicated. Associations were examined overall and in strata of hypertension stage, 10-year atherosclerotic cardiovascular disease (ASCVD) risk, age, and sex. Results: Among 12,467 adults followed a median of 24 years (mean age at enrollment 54.1 ± 5.8 years, 55% women, 26% Black adults), 3,000 (24%) had a standing SBP < 110 mm Hg. A standing SBP < 110 mm Hg compared to standing SBP ≥ 110 mm Hg was not significantly associated with falls or syncope, and was associated with a lower risk of CHD events and mortality with HRs of 1.02 (95% CI 0.94, 1.11), 1.02 (0.93, 1.11), 0.88 (0.80, 0.97), and 0.91 (0.86, 0.97), respectively. There were no clinically meaningful differences when stratified by hypertension stage, 10-year ASCVD risk, age, and sex. Conclusions: In this community-based population, low standing SBP was common and not significantly associated with falls or syncope, but was associated with a lower risk of CHD and mortality. These findings do not support screening for low standing BP as a risk factor for adverse events. (© The Author(s) 2023. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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