title: Orthostatic Hypotension and Cardiac Changes After Long-Term Follow-Up.
abstract: Orthostatic hypotension (OH) increases the risk of incident cardiovascular disease (CVD) and all-cause mortality in population-based cohort studies. Whether OH is associated with development of cardiac anomalies has not been sufficiently explored.
  
  
  
  In the prospective population-based Malmö Preventive Project (MPP), a subset of 974 non-diabetic individuals (mean age: 67 years; 29% women) were examined with echocardiography after a mean follow-up period of 23±4 years from baseline. The association of increased left ventricular mass (LVM), pathological cardiac chamber volumes, echocardiographic parameters of systolic and diastolic dysfunction in relation to the presence of OH at baseline, defined as decrease in systolic ≥20mm Hg and/or diastolic blood pressure (BP) ≥10mm Hg upon standing, was studied.
  
  
  
  Among reexamined MPP participants, 40 (4.1%) met OH criteria during baseline screening. In the multivariable-adjusted Cox proportional hazard models, taking demographics, BP, and antihypertensive treatment (AHT) into account, OH predicted left ventricular hypertrophy (LVH) (hazard ratio (HR): 1.97, 1.01-3.84; P = 0.047), decreased right chamber volume (HR: 1.74, 1.19-2.57; P = 0.005), and reduced early diastolic tissue velocity in septal wall (HR: 1.47, 1.01-2.14; P = 0.045). No significant associations were seen between OH and atrial chamber volumes, LV volume, and LV systolic function.
  
  
  
  The presence of OH among middle-aged adults is associated with the development of structural cardiac changes such as LVH and declining right chamber volume, as well as with the development of diastolic dysfunction, independently of traditional risk factors. These findings may contribute to the understanding of how prevalent OH impacts the risk of CVD.
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden;
authors.forename: Martin
authors.initials: M
authors.lastname: Magnusson
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden;
authors.forename: Hannes
authors.initials: H
authors.lastname: Holm
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Medicine, Ystad Hospital, Ystad, Sweden.
authors.forename: Erasmus
authors.initials: E
authors.lastname: Bachus
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden;
authors.forename: Peter
authors.initials: P
authors.lastname: Nilsson
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden;
authors.forename: Margret
authors.initials: M
authors.lastname: Leosdottir
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden;
authors.forename: Olle
authors.initials: O
authors.lastname: Melander
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden;
authors.forename: Amra
authors.initials: A
authors.lastname: Jujic
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden; artur.fedorowski@med.lu.se.
authors.forename: Artur
authors.initials: A
authors.lastname: Fedorowski
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007024:Hypotension, Orthostatic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D013548:Sweden / Q000453:epidemiology
keywords: blood pressure; diastolic heart failure; echocardiography; heart ventricles; left ventricular hypertrophy; orthostatic hypotension.