title: The association between orthostatic hypotension and medication use in the British Women's Heart and Health Study.
abstract: OBJECTIVE
  to determine the prevalence of orthostatic hypotension (OH) and associations with medication use in community-dwelling older women.
  
  
  METHODS
  cross-sectional analysis using data from the British Women's Heart and Health Study.
  
  
  METHODS
  general practices in 23 towns in the UK.
  
  
  METHODS
  3,775 women aged 60-80 years from 1999 to 2001.
  
  
  METHODS
  orthostatic hypotension-drop of > or =20 mmHg in systolic and/or a drop of > or =10 mmHg in diastolic blood pressure on standing.
  
  
  RESULTS
  prevalence of OH was 28% (95% confidence interval [CI] 26.6, 29.4), which increased with age and hypertension. Regardless of treatment status or diagnosed hypertension, raised blood pressure was strongly associated with OH (P < 0.001). OH was strongly associated with number of antihypertensives taken (none vs three or more: odds ratio [OR] 2.24, 95% CI 1.47-3.40, P < 0.001); the association was slightly attenuated after allowing for age and co-morbidities (OR 1.99; 95% CI 1.30, 3.05; P = 0.003). Women with multiple co-morbidities had markedly increased odds of OH independent of age, number and type of medications taken (none vs four or more diagnoses: OR 2.28, 95% CI 1.58-3.30, P = 0.005).
  
  
  CONCLUSIONS
  uncontrolled hypertension, use of three or more antihypertensives and multiple co-morbidities are predictors of OH in older women. Detection or monitoring of OH in these groups may prevent women from suffering its adverse consequences.
authors.affiliation: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK. shahrul.kamaruzzaman@lshtm.ac.uk
authors.forename: Shahrul
authors.initials: S
authors.lastname: Kamaruzzaman
authors.forename: Hilary
authors.initials: H
authors.lastname: Watt
authors.forename: Claire
authors.initials: C
authors.lastname: Carson
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
mesh_terms: D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors