Postural changes in diastolic blood pressure and the risk of myocardial infarction: the Normative Aging Study.

Sparrow, David; Tifft, Charles P.; Rosner, Bernard; Weiss, Scott T.

doi:10.1161/01.cir.70.4.533

Cited by 63 publications

(33 citation statements)

References 17 publications

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“…Few prospective studies have evaluated the association of OH with stroke, although several have evaluated the association between OH and various vascular outcomes 24,25,29 or allcause mortality. 26 -28 In 2 studies, OH was related to coronary heart disease 24 and all-cause mortality 28 independently of other risk factors.…”

Section: Oh As a Risk Factor For Ischemic Strokementioning

confidence: 99%

“…9,21,22 One cross-sectional study that evaluated 3 definitions of OH suggested that each type of OH identifies a population subgroup characterized by different sets of risk factors. 23 Longitudinal studies evaluating OH and cardiovascular disease 24,25 or mortality 26 -29 include the Honolulu Heart Study, in which both systolic and diastolic OH were predictive of all-cause mortality, 28 and a Finnish study in which only diastolic OH was associated with increased vascular mortality. 29 OH is not even listed as a potential risk factor for stroke in several reviews, 3,4,6 and most prospective investigations of stroke have not evaluated OH as a risk factor.…”

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confidence: 99%

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Orthostatic Hypotension as a Risk Factor for Stroke

Eigenbrodt

Rose

Couper

et al. 2000

Stroke

308

116

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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 Ն20 mm Hg (systolic OH), a diastolic blood pressure drop Ն10 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.

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Section: Oh As a Risk Factor For Ischemic Strokementioning

confidence: 99%

mentioning

confidence: 99%

Orthostatic Hypotension as a Risk Factor for Stroke

Eigenbrodt

Rose

Couper

et al. 2000

Stroke

308

116

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“…These include pulse and mean arterial pressure4 and postural changes in blood pressure. 13 When a person assumes the upright posture, cardiovascular adjustments occur to maintain the blood pressure. These actions include reflex arteriolar and venous constriction, reflex acceleration of heart rate, increase in muscle tone, and an immediate increase in plasma catecholamines.…”

mentioning

confidence: 99%

The association of postural changes in systolic blood pressure and mortality in persons with hypertension: the Hypertension Detection and Follow-up Program experience.

Davis¹,

Langford²,

Blaufox³

et al. 1987

Circulation

114

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340-346, 1987. MANY epidemiologic studies have identified blood pressure as an important risk factor for both cardiovascular disease and total mortality. 12 Elevated levels of either diastolic blood pressure (DBP) or systolic blood pressure (SBP) are associated with an increased mortality risk. As a result of these findings, the importance of the detection and treatment of individuals with high blood pressure has been established.Several pressure measures have been used to improve predictability of subsequent cardiovascular morFrom the Hypertension Detection and Follow-up Program, The

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“…Studies of the association between blood pressure reactivity and the subsequent development of hypertension [1][2][3][4][5] and coronary heart disease (CHD) or stroke [6][7][8][9] have been inconclusive. Associations with elevated serum cholesterol (eg Vogele 10 and Bardwell et al 11 ), fasting glucose levels/insulin sensitivity, 11,12 and atherosclerosis 13 also have been inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure and pulse responses to three stressors: associations with sociodemographic characteristics and cardiovascular risk factors

et al. 2004

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Cardiovascular reactivity is hypothesized to increase the risk of hypertension and other CVD-related conditions. However, studies to date are inconclusive. We compared the association of blood pressure and pulse responses to three stressors (postural challenge, handgrip test, mental arithmetic) with sociodemographic characteristics and CVD risk factors. We included 782 participants from the Hypertension Genetic Epidemiology Study. Blood pressure and pulse responses to stressors were defined as the difference between postand pre-stress measurements. Stepwise regression analyses examined change in SBP and pulse in response to stressors as a function of sociodemographic and CVD risk factors. Age, race, and gender were forced into models and other variables (education, BMI, waist circumference, resting SBP and DBP, cigarette smoking, LDL and HDL cholesterol, glucose, and antihypertensive medications (beta-blockers, calcium channel blockers, diuretics, ace inhibitors)) were retained if Po0.10. Age was a significant predictor of SBP response to all stressors. The SBP response to a change in posture was not related to other variables. The SBP response to mental arithmetic was significantly higher among men, those with larger waists, higher SBP, betablocker users, and lower among smokers. SBP response to the handgrip was significantly higher among those with higher SBP and beta-blocker users. Similarly, the association of the pulse response to the risk factors varied considerably across the stressors. Overall, the socio-demographic and CVD risk factors accounted for between 9 and 14% of the variance in the SBP response to the stressors and from between 4 and 12% of the variance in the pulse response to the three stressors. The associations between sociodemographic and CVD risk factors and the SBP and pulse response to stress were modest and inconsistent across stressors. The findings suggest that cardiovascular reactivity is a concept that needs to be defined in reference to specific stressors so that mechanisms leading to responses can be better understood.

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Postural changes in diastolic blood pressure and the risk of myocardial infarction: the Normative Aging Study.

Cited by 63 publications

References 17 publications

Orthostatic Hypotension as a Risk Factor for Stroke

Orthostatic Hypotension as a Risk Factor for Stroke

The association of postural changes in systolic blood pressure and mortality in persons with hypertension: the Hypertension Detection and Follow-up Program experience.

Blood pressure and pulse responses to three stressors: associations with sociodemographic characteristics and cardiovascular risk factors

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