Postural BP drop predicts heart failure

ORTHOSTATIC hypotension may be a marker for a propensity to develop heart failure, researchers say.

In a study of more than 12,000 adults free of heart failure at baseline, US researchers found that orthostatic hypotension was an independent predictor of incident clinical heart failure over the next 17 years.

Having orthostatic hypotension at baseline – defined as a decrease of 20mmHg or more in systolic BP or 10mmHg or more in diastolic BP – was more common among those developing heart failure compared to those who did not (11% vs 4%) develop it.

People with orthostatic hypotension had a 34% increased risk of heart failure, after excluding those with high BP. 

The association was maintained when patients taking ACE inhibitors, beta-blockers, diuretics, psychiatric or Parkinson’s disease medications were excluded.

The association between orthostatic hypotension and heart failure did not differ substantially between gender or races, but was stronger for people aged 45–55 years.

“Hypertension, diabetes and coronary heart disease are already known to contribute to a person’s risk of developing heart failure,” lead author Dr Christine DeLong Jones said.

“Orthostatic blood pressure measurement may supplement what is already known about the risk of heart failure and requires no additional equipment, just a standard blood pressure cuff.”

Hypertension 2012, in press