Orthostatic changes in systolic blood pressure among SPRINT participants at baseline

Document Type

Article

Publication Date

11-1-2016

Publication Title

J Am Soc Hypertens

Abstract

Orthostatic changes in systolic blood pressure (SBP) impact cardiovascular outcomes. In this study, we aimed to determine the pattern of orthostatic systolic pressure changes in participants enrolled in the SBP Intervention Trial (SPRINT) at their baseline visit before randomization and sought to understand clinical factors predictive of these changes. Of the 9323 participants enrolled in SPRINT, 8662 had complete data for these analyses. The SBP after 1 minute of standing was subtracted from the mean value of the three preceding seated SBP values. At the baseline visit, medical history, medications, anthropometric measures, and standard laboratory testing were undertaken. The mean age of SPRINT participants was 68 years, two-thirds were male, with 30% black, 11% Hispanic, and 55% Caucasian. The spectrum of SBP changes on standing demonstrated that increases in SBP were as common as declines, and about 5% of participants had an increase, and 5% had a decrease of >20 mm Hg in SBP upon standing. Female sex, taller height, more advanced kidney disease, current smoking, and several drug classes were associated with larger declines in BP upon standing, while black race, higher blood levels of glucose and sodium, and heavier weight were associated with more positive values of the change in BP upon standing. Our cross-sectional results show a significant spectrum of orthostatic SBP changes, reflecting known (eg, age) and less well-known (eg, kidney function) relationships that may be important considerations in determining the optimal target blood pressure in long-term outcomes of older hypertensive patients.

Medical Subject Headings

Age Factors; Aged; Aged, 80 and over; Antihypertensive Agents; Blood Pressure; Blood Pressure Determination; Body Height; Cross-Sectional Studies; Female; Glomerular Filtration Rate; Humans; Hypertension; Hypotension, Orthostatic; Male; Middle Aged; Posture; Renal Insufficiency, Chronic; Risk Factors; Sex Factors; Systole

PubMed ID

27665708

Volume

10

Issue

11

First Page

847

Last Page

856

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