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Intensive Therapy for HTN Tied to Drop in Orthostatic Hypotension

Meta-analysis of trials shows risk for OH reduced with intensive blood pressure treatment for hypertension

TUESDAY, Sept. 15, 2020 (HealthDay News) -- Intensive blood pressure (BP)-lowering treatment in adults with hypertension is associated with a reduced likelihood of orthostatic hypotension (OH), according to a review published online Sept. 10 in the Annals of Internal Medicine to coincide with the American Heart Association Hypertension 2020 Scientific Sessions, held virtually from Sept. 10 to 13.

Stephen P. Juraschek, M.D., Ph.D., from Harvard Medical School in Boston, and colleagues examined the effects of intensive BP-lowering treatment on OH in adults with hypertension. Data were included from randomized trials of BP pharmacologic treatment that involved more than 500 adults with hypertension or elevated BP. Five trials assessed BP treatment goals, and four compared active agents with placebo.

A total of 18,466 participants with 127,882 follow-up visits were included in the trials examining BP treatment goals. The trials were open-label; across trials, there was minimal heterogeneity of effects. The researchers found that the risk for OH was reduced with intensive BP-lowering treatment (odds ratio, 0.93). There was no difference in the effects by prerandomization OH (P for interaction = 0.80). Overall and subgroup findings were unchanged in sensitivity analyses that included four additional placebo-controlled trials.

"Our findings should challenge the traditional teaching about blood pressure treatment causing orthostatic hypotension, reassuring clinicians about the safety of blood pressure treatment with regard to this condition," Juraschek said in a statement.

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