Effect of orthostatic hypotension on long-term prognosis of elderly patients with stable coronary artery disease: a retrospective cohort study

被引：1

作者：

Hu, Jiaman ^{[1
,2
,3
,4
]}

Chi, Jianing ^{[5
]}

Cai, Hua ^{[6
]}

Wu, Ningxia ^{[6
]}

Li, Pengfei ^{[1
,2
,3
]}

Huang, Yuekang ^{[1
,2
,3
]}

Lin, Cailong ^{[1
,2
,3
]}

Lai, Yingying ^{[1
,2
,3
]}

Huang, Jianyu ^{[1
,2
,3
]}

Li, Weihua ^{[1
,2
,3
]}

Su, Peng ^{[1
,2
,3
]}

Li, Min ^{[1
,2
,3
]}

Lin, Zhongqiu ^{[7
]}

Xu, Lin ^{[1
,2
,3
,4
]}

机构：

[1] Gen Hosp Southern Theater Command, Dept Geriatr Cardiol, Guangzhou, Peoples R China

[2] Gen Hosp Southern Theater Command, Branch Natl Clin Res Ctr Geriatr Dis, Guangzhou, Peoples R China

[3] Gen Hosp Southern Theater Command, Guangzhou Key Lab Cardiac Rehabil, Guangzhou, Peoples R China

[4] Guangdong Pharmaceut Univ, Sch Publ Hlth, Guangzhou, Peoples R China

[5] Southern Med Univ, Sch Clin Med 1, Guangzhou, Peoples R China

[6] Guangzhou Univ Chinese Med, Grad Sch, Guangzhou, Peoples R China

[7] South China Univ Technol, Affiliated Hosp 6, Sch Med, Foshan, Peoples R China

来源：

FRONTIERS IN CARDIOVASCULAR MEDICINE | 2024年 / 11卷

基金：

中国国家自然科学基金;

关键词：

stable coronary artery disease; orthostatic hypotension; all-cause mortality; cardiovascular disease mortality; prognosis; cohort study; BLOOD-PRESSURE CHANGE; CARDIOVASCULAR-DISEASE; RISK; MORTALITY; HYPERTENSION; METAANALYSIS; PEOPLE;

D O I：

10.3389/fcvm.2024.1342379

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The long-term prognosis of patients with stable coronary artery disease (CAD) combined with orthostatic hypotension (OH) has rarely been reported. This research was designed to examine whether OH increases the risk of all-cause mortality and cardiovascular death among patients with stable CAD. Methods: We retrospectively analyzed retired military personnel over 65 years of age who were hospitalized at the General Hospital of Southern Theater Command of the Chinese People's Liberation Army between March and July 2010. A total of 924 patients with stable CAD were included, among whom 263 had OH. The risk of all-cause mortality and cardiovascular death in OH and non-OH groups were analyzed with the Cox proportional hazards models, and restricted cubic spline plots were utilized for subgroup analyses. Furthermore, competing risk models were applied for sensitivity analyses. Results: The median age of the patients was 82.00 (80.00-85.00) years. Over 159 months of follow-up, the loss to follow-up rate was 2.27%, and all-cause mortality was observed in 574 (63.57%) patients, including 184 with OH. Moreover, cardiovascular death occurred in 127 patients (13.73%), with 58 cases associated with OH. Although the relationship between OH and all-cause mortality was non-significant [body mass index (BMI) < 25 group, adjusted hazard ratio (HR) = 1.10 with a 95% confidence interval (CI): 0.82-1.40; BMI >= 25 group, adjusted HR = 1.30, 95% CI: 0.98-1.70], it was independently related to a growing risk of cardiovascular death (adjusted HR = 1.80, 95% CI: 1.20-2.60). This finding was further validated by using a competing risk model (subdistribution HR = 1.74, 95% CI: 1.22-2.49). Moreover, age, low-density lipoprotein cholesterol, and frequency of hospital admissions were identified as risk factors of cardiovascular death among patients with OH (P < 0.05). Conclusion: Our study, based on retired military personnel with stable CAD, found that OH led to a significantly higher risk of cardiovascular death, but it was not noticeably associated with all-cause mortality on long-term prognosis.

引用

页数：11