Orthostatic hypotension and the incidence of coronary heart disease: The atherosclerosis risk in communities study

We examined the association between orthostatic hypotension (OH) at baselin e examination (1987-1989) and the incidence of coronary heart disease (CHD) over an average of 6 years, among 12,433 black and white middle-aged men a nd women participating in the Atherosclerosis Risk in Communities (ARIC) st udy. OH was defined as a SEP decrease greater than or equal to 20 mm Hg or a DBP decrease greater than or equal to 10 mm Hg after changing from supine to standing. CHD events included definite or probable myocardial infarctio ns (MI), silent MI, and fatal CHD. Five percent of participants had OH. Pre valence increased with advancing age and was more common among those with c ardiovascular disease (CVD)-related comorbidities and risk factors. Those w ith OH had an increased risk of CHD (hazard ratio [HR] = 3.49, 95% confiden ce interval [CI] = 2.58, 4.73). This association was attenuated after contr olling for age, ethnicity, gender, comorbid conditions, and CVD risk factor s (HR = 1.85, 95% CI = 1.31, 2.63). Am J Hypertens 2000;13:571-578 (C) 2000 American Journal of Hypertension, Ltd.