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      Orthostatic Hypotension and Risk of Venous Thromboembolism in 2 Cohort Studies

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          Abstract

          BACKGROUND

          Although venous stasis is a risk factor for venous thromboembolism (VTE) and orthostatic hypotension (OH) can cause venous stasis, to our knowledge no study has examined the relationship between OH and VTE risk. We sought to quantify the association between OH and VTE (deep vein thrombosis or pulmonary embolism) using data from 2 large, prospective cohort studies: the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities (ARIC) Study. We hypothesized that OH was positively associated with incident VTE.

          METHODS

          We measured OH—defined as a drop in systolic blood pressure (SBP) of at least 20mm Hg or diastolic blood pressure (DBP) of at least 10mm Hg within 3 minutes of standing—in participants aged 45–64 years in ARIC ( n = 12,480) and ≥65 years in CHS ( n = 5,027) at baseline visits (1987–1989 in ARIC; 1989–1990 and 1992–1993 in CHS), and followed participants for incident VTE ( n = 568 in ARIC through 2011 and n = 148 in CHS through 2001). We calculated adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for incident VTE in relation to OH status.

          RESULTS

          In CHS, there was a positive association between OH status and incident VTE (HR for VTE = 1.74 (95% CI: 1.20–2.51)). In contrast, there was no association between OH and VTE in the ARIC study (HR for VTE = 0.97 (95% CI: 0.70–1.33)).

          CONCLUSIONS

          Community-dwelling older adults with OH had a moderately increased risk of VTE. These results were not seen in a population-based middle-aged cohort.

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          Author and article information

          Journal
          Am J Hypertens
          Am. J. Hypertens
          ajh
          ajh
          American Journal of Hypertension
          Oxford University Press (US )
          0895-7061
          1941-7225
          May 2016
          25 August 2015
          : 29
          : 5
          : 634-640
          Affiliations
          1 Division of Epidemiology & Community Health, University of Minnesota , Minneapolis, Minnesota, USA;
          2 Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA ;
          3 Department of Medicine, Division of Hematology/Oncology, University of Vermont, Burlington, Vermont, USA ;
          4 Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, Washington, USA .
          Author notes
          Correspondence: Elizabeth J. Bell ( ebell@ 123456umn.edu ).
          Article
          PMC5014082 PMC5014082 5014082
          10.1093/ajh/hpv151
          5014082
          26306405
          000b4996-caee-4ae9-a1b4-19228b27aef9
          © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com
          History
          : 9 June 2015
          : 6 August 2015
          : 6 July 2015
          Page count
          Pages: 7
          Funding
          Funded by: National Heart, Lung, and Blood Institute http://dx.doi.org/10.13039/100000050
          Award ID: HHSN268201100005C
          Award ID: HHSN268201100006C
          Award ID: HHSN268201100007C
          Award ID: HHSN268201100008C
          Award ID: HHSN2682 01100009C
          Award ID: HHSN268201100010C
          Award ID: HHSN268201100011C
          Award ID: HHSN268201100012C
          Funded by: National Institute of Neurological Disorders and Stroke http://dx.doi.org/10.13039/100000065
          Funded by: National Institute on Aging http://dx.doi.org/10.13039/100000049
          Categories
          Original Article
          Blood Vessels

          epidemiology,hypertension,orthostatic hypotension,orthostatic intolerance,venous thromboembolism.,risk factors,blood pressure

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