@article{ref1,
title="Standing blood pressure and risk of falls, syncope, coronary heart disease, and mortality",
journal="American journal of hypertension",
year="2023",
author="Kondo, Jordan K. and Earle, William and Turkson-Ocran, Ruth-Alma N. and Ngo, Long H. and Cluett, Jennifer L. and Lipsitz, Lewis A. and Daya, Natalie R. and Selvin, Elizabeth and Lutsey, Pamela L. and Coresh, Josef and Windham, Beverly Gwen and Kendrick, Karla N. and Juraschek, Stephen P.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: ACC/AHA guidelines caution against the use of antihypertensive therapy in the setting of low standing systolic BP (SBP) <110 mmHg due to unclear benefits. <br><br>METHODS: The Atherosclerosis Risk in Communities (ARIC) Study measured supine and standing SBP in adults aged 45-64 years between 1987-1989. We used Cox regression to evaluate the associations of low standing SBP (<110 mmHg) 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. <br><br>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), 3000 (24%) had a standing SBP <110 mmHg. A standing SBP <110 mmHg compared to standing SBP ≥110 mmHg 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. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="0895-7061",
doi="10.1093/ajh/hpad064",
url="http://dx.doi.org/10.1093/ajh/hpad064"
}