Document Detail


The association of postural changes in systolic blood pressure and mortality in persons with hypertension: the Hypertension Detection and Follow-up Program experience.
MedLine Citation:
PMID:  3802437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Participants in the Hypertension Detection and Follow-up Program (HDFP) were classified on the basis of baseline standing minus sitting systolic blood pressure into four groups (less than or equal to -20 [group 1], -19 to 0 [group 2], 1 to 20 [group 3], and greater than 20 mm Hg [group 4]) to study 5 year mortality. Group 1, 3.3% of the total, contained those participants who had postural hypotension. The 5 year total and age-adjusted mortality rates for these groups were significantly different (p less than .04), with group 1 having the highest rates. To account for the possible confounding effects of certain baseline risk factors--age, sex, race, prior antihypertensive treatment, randomization group, diabetes, end-organ damage, sitting diastolic and systolic blood pressures, pulse, hematocrit, smoking status, and relative weight (percent of ideal weight)--in assessing group differences in mortality rates, a multiple logistic model was used. Relative weight proved to be a confounding factor for the association of drop in postural systolic blood pressure with mortality. However, there is an interaction between history of diabetes and postural change in systolic blood pressure. Thus, postural hypotension may indicate a poor prognosis in diabetic hypertensive patients.
Authors:
B R Davis; H G Langford; M D Blaufox; J D Curb; B F Polk; N B Shulman
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  75     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1987 Feb 
Date Detail:
Created Date:  1987-02-27     Completed Date:  1987-02-27     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  340-6     Citation Subset:  AIM; IM; S    
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adult
Aged
Blood Pressure
Diabetes Mellitus / mortality
Female
Follow-Up Studies
Humans
Hypertension / mortality*
Hypotension, Orthostatic / mortality*
Male
Mass Screening
Middle Aged
Models, Biological
Prognosis
Regression Analysis
Grant Support
ID/Acronym/Agency:
N01-HV-12433/HV/NHLBI NIH HHS; N01-HV-22931/HV/NHLBI NIH HHS; N01-HV-22937/HV/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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