Takeaway
- Orthostatic hypotension (OH) was associated with increased risk for dementia and cognitive decline and may be a clinically useful indicator of increased risk.
- Subclinical orthostatic hypotension (SOH) can also be considered as a risk factor in older adults with hypertension.
Why this matters
- OH has been associated with an increased risk of incident dementia but limited data are available in those at highest risk, the hypertensive oldest-old.
Study design
- Integrated evidence review and analysis of 3121 participants (aged ≥80 years; with OH, n=538; without OH, n=2583) with hypertension included from the Hypertension in the Very Elderly Trial cohort.
- Cognitive function was assessed at baseline and annually using the Mini-Mental State Exam score.
- Funding: None disclosed.
Key results
- Among patients with OH, increased risks for cognitive decline (194 events; aHR, 1.36; 95% CI, 1.15-1.59) and incident dementia (50 events; aHR, 1.34; 95% CI, 0.98-1.84) were observed.
- Minor changes in risk were observed using composite endpoints on combining cognitive decline and cardiovascular outcomes (aHR, 1.39; 95% CI, 1.19-1.62) and on combining dementia and cardiovascular outcomes (aHR, 1.34; 95% CI, 1.05-1.72).
- SOH showed an increased risk for cognitive decline (aHR, 1.56; 95% CI, 1.12-2.17) and dementia (aHR, 1.79; 95% CI, 1.00-3.20).
Limitations
- Short follow-up duration.
References
References
