Orthostatic hypotension and the risk of atrial fibrillation and other cardiovascular diseases: An updated meta-analysis of prospective cohort studies

J Clin Hypertens (Greenwich). 2019 Aug;21(8):1221-1227. doi: 10.1111/jch.13613. Epub 2019 Jul 10.

Abstract

The relationships between orthostatic hypotension (OH) and some kinds of cardiovascular disease are inconsistent among studies. This updated meta-analysis was conducted in hopes of producing progress on this topic. A systematic database search was performed in electronic databases, including the Chinese Biomedical Database (CBM), PubMed, Web of Science, and the Cochrane Library. Summary hazard ratio (HR) estimates with 95% confidence intervals (CIs) were calculated by a random-effects model. Statistical heterogeneity was assessed with Cochran's Q test and the I2 statistic. From 1462 potentially eligible records, 15 studies met the inclusion criteria. Subjects with OH had a high risk of heart failure (HF) and atrial fibrillation (AF) (pooled HR 1.34, 95% CI 1.17-1.52, P < 0.001 and pooled HR 1.51, 95% CI 1.28-1.79, P < 0.001, respectively). This meta-analysis also showed significant associations between OH and the risks of developing coronary heart disease (CHD) (pooled HR 1.44, 95% CI 1.18-1.75, P < 0.001) and myocardial infarction (MI) (pooled HR 1.52, 95% CI 1.12-2.06, P = 0.008). Our study suggests that OH is positively associated with high risks of HF and AF. Moreover, it may be related to high risks of CHD and MI.

Keywords: atrial fibrillation; coronary heart disease; heart failure; myocardial infarction; orthostatic hypotension.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / etiology*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Coronary Disease / epidemiology
  • Coronary Disease / etiology
  • Female
  • Humans
  • Hypotension, Orthostatic / complications*
  • Hypotension, Orthostatic / epidemiology
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / etiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Sensitivity and Specificity