title: Orthostatic Hypotension and Risk of Venous Thromboembolism in 2 Cohort Studies.
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 20 mm Hg or diastolic blood pressure (DBP) of at least 10 mm 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.
authors: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA; ebell@umn.edu.
authors: Elizabeth J
authors: EJ
authors: Bell
authors: Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA;
authors: Sunil K
authors: SK
authors: Agarwal
authors: Department of Medicine, Division of Hematology/Oncology, University of Vermont, Burlington, Vermont, USA;
authors: Mary
authors: M
authors: Cushman
authors: Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, Washington, USA.
authors: Susan R
authors: SR
authors: Heckbert
authors: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA;
authors: Pamela L
authors: PL
authors: Lutsey
authors: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA;
authors: Aaron R
authors: AR
authors: Folsom
mesh_terms: D000368:Aged; D001794:Blood Pressure; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology*
keywords: blood pressure; epidemiology; hypertension; orthostatic hypotension; orthostatic intolerance; risk factors; venous thromboembolism.