- Intensive BP lowering is not linked to orthostatic hypotension, according to the results of this meta-analysis of 9 randomized trials.
Why this matters
- These authors say that onset of orthostatic hypotension should not be viewed as a reason to dial back or cease BP-lowering therapy.
- The analysis included 5 open-label randomized treatment-goal trials (including SPRINT) with a total of 18,466 participants (range, 1090-9361).
- They also analyzed data from 4 separate placebo-controlled trials.
- BP goals varied in targets, e.g., a range of systolic BP targets from
- Intertrial heterogeneity was low.
- Orthostatic hypotension was decreased across treatment-goal trials.
- SPRINT had the strongest association of BP reduction with reduced orthostatic hypotension odds: OR, 0.89 (95% CI, 0.80-0.98).
- The placebo-controlled trials showed no effect.
- Pooling all 9 trials yielded lower orthostatic hypotension risk with intensive BP treatment: OR, 0.93 (95% CI, 0.89-0.98).
- No effects by sex, etc., seen.
- Meta-analysis, systematic review.
- Funding: National Heart, Lung, and Blood Institute; NIH.
- No data on falls, syncope.