The association between orthostatic hypotension and medication use in the British Women's Heart and Health Study
Abstract
OBJECTIVE: to determine the prevalence of orthostatic hypotension (OH) and associations with medication use in community-dwelling older women. DESIGN: cross-sectional analysis using data from the British Women's Heart and Health Study. SETTING: general practices in 23 towns in the UK. PARTICIPANTS: 3,775 women aged 60-80 years from 1999 to 2001. MAIN OUTCOME MEASURE: orthostatic hypotension-drop of > or =20 mmHg in systolic and/or a drop of > or =10 mmHg in diastolic blood pressure on standing. RESULTS: prevalence of OH was 28% (95% confidence interval [CI] 26.6, 29.4), which increased with age and hypertension. Regardless of treatment status or diagnosed hypertension, raised blood pressure was strongly associated with OH (P < 0.001). OH was strongly associated with number of antihypertensives taken (none vs three or more: odds ratio [OR] 2.24, 95% CI 1.47-3.40, P < 0.001); the association was slightly attenuated after allowing for age and co-morbidities (OR 1.99; 95% CI 1.30, 3.05; P = 0.003). Women with multiple co-morbidities had markedly increased odds of OH independent of age, number and type of medications taken (none vs four or more diagnoses: OR 2.28, 95% CI 1.58-3.30, P = 0.005). CONCLUSION: uncontrolled hypertension, use of three or more antihypertensives and multiple co-morbidities are predictors of OH in older women. Detection or monitoring of OH in these groups may prevent women from suffering its adverse consequences.
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The total number of BP-lowering medications or the use of three or more antihypertensive drugs may be a significant predictor of OH.
“The total number of BP-lowering medications 313 or the use of three or more antihypertensive drugs may be a significant predictor of OH. 314”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [314]
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- Authors
- Kamaruzzaman, S., Watt, H., Carson, C., & Ebrahim, S.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-11-06
- Volume
- 39
- Issue
- 1
- Pages
- 51-56
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W2149148768
- Cited by
- 182
- References
- 35
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 6 · 2023: 6 · 2022: 14 · 2021: 13 · 2020: 13 · 2019: 19 · 2018: 17 · 2017: 15 · 2016: 8 · 2015: 10 · 2014: 10 · 2013: 14 · 2012: 11
- FWCI
- 8.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- British Heart Foundation
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- orthostatic hypotension, medication use, antihypertensive drugs, hypertension, older women, comorbidities, prevalence, blood pressure, British Women's Heart and Health Study
- MeSH terms
- Age Factors, Aged, Blood Pressure, Cross-Sectional Studies, England, Humans, Hypertension, Hypotension, Orthostatic, Risk Factors, Prevalence
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