Lower Systolic BP Goal May Cut Risk for Orthostatic Hypotension
MONDAY, Sept. 9, 2019 -- In adults with recent stroke, a lower systolic blood pressure (SBP) goal may reduce the risk for orthostatic hypotension (OH) without any effect on orthostatic symptoms, according to a study presented at the American Heart Association Hypertension 2019 Scientific Sessions, held from Sept. 5 to 8 in New Orleans.
Stephen P. Juraschek, M.D., Ph.D., from Harvard Medical School in Boston, and colleagues examined the effect of SBP goal on OH. Adults with recent stroke (mean age, 62.8 years) were randomly assigned to an SBP goal of either 130 to 149 mm Hg or <130 mm Hg. BP was measured three times in a seated position and once after two minutes of standing during follow-up.
The researchers found that OH was present 2,591 times in 1,165 participants during 36,342 visits involving 2,876 participants with a mean of 15 follow-up visits. Dizziness was present 1,343 times in 592 participants, and lightheadedness occurred 941 times in 893 participants. Compared with a standard SBP goal, a lower goal was associated with a reduced risk for OH (odds ratio, 0.86), an increased risk for SBP ≤90 mm Hg or diastolic BP (DBP) ≤40 mm Hg (odds ratios, 3.79 and 2.42, respectively), and a reduced risk for SBP ≥190 mm Hg or DBP ≥110 mm Hg (odds ratios, 0.40 and 0.31, respectively). Dizziness or lightheadedness were not affected by BP goal.
"Our study provides strong evidence that intense blood pressure treatment does not induce orthostatic hypotension or its symptoms," Juraschek said in a statement.
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Posted: September 2019