Orthostatic hypotension and cardiovascular risk.

Orthostatic hypotension and cardiovascular risk. Kardiol Pol. 2019 Nov 08;: Authors: Fedorowski A, Ricci F, Sutton R Abstract Orthostatic hypotension (OH) is a cardinal sign of cardiovascular (CV) autonomic dysfunction as a result of autonomic nervous system failure to control the postural hemodynamic homeostasis. The proportion of individuals with OH increases with aging and chronic conditions, such as neurodegenerative diseases, hypertension, heart failure, diabetes, renal dysfunction, autoimmune diseases and cancer. In those over 70 years, more than 20% can be affected. It is now increasingly recognized that a direct relationship exists between OH and each step of the CV disease continuum, eventually leading to end-stage heart disease and CV death. In particular, prevalent OH is associated with cardiac functional and structural remodeling, left ventricular hypertrophy, elevated levels of circulating markers of inflammation, increased intima-media thickness, subclinical atherosclerosis, and thrombosis. Beyond subclinical changes, presence of OH independently predicts coronary events, stroke, atrial fibrillation, heart failure, and CV mortality. Furthermore, OH is associated with syncope, falls and fragility fractures, presenting hurdles to be overcome in delivery of best management of CV risk factors. Taken together, OH heralds disruption of global circulatory homeostasis and flags overt autonomic dysfunction. Presence of OH is als...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research