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Association between invasively measured aortic pulse pressure and orthostatic hypotension in patients undergoing invasive coronary angiography.

Abstract：

OBJECTIVE:Underlying pathophysiology of orthostatic hypotension has been poorly understood. We hypothesized that aortic pulse pressure (APP) reflecting aortic stiffness may be involved in the development of orthostatic hypotension. METHODS:A total of 200 patients (age 64.3 ± 10.9 years, 62.5% men) who underwent invasive coronary angiography (ICA) were prospectively recruited. Orthostatic hypotension was defined as SBP drop at least 20 mmHg or DBP drop at least 10 mmHg within 3 min of the standing position compared with the supine position. Hemodynamic parameters were measured at the ascending aorta using a pig-tail catheter immediately before ICA. APP was calculated as a difference between the aortic peak systolic pressure and the end-diastolic pressure. RESULTS:A total of 156 patients (78.0%) had obstructive coronary artery disease on ICA. Orthostatic hypotension was present in 58 patients (29.0%). Diabetes mellitus was more prevalent in patients with orthostatic hypotension than those without (48.3% vs. 23.2%; P < 0.001). Other clinical parameters including age, cardiovascular risk factors, laboratory findings and concomitant medications were not different between patients with and without orthostatic hypotension (P > 0.05 for each). In hemodynamic parameters, APP was higher in patients with orthostatic hypotension than those without (78.4 ± 25.8 vs. 68.3 ± 21.3 mmHg; P = 0.005). Higher APP was significantly associated with the presence of orthostatic hypotension even after controlling for potential confounders (odds ratio, 2.99; 95% confidence interval 1.15-7.78; P = 0.025). CONCLUSION:In patients undergoing ICA, APP was associated with increased risk of orthostatic hypotension. Central aortic stiffness may play a role in the development of orthostatic hypotension.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Chung J,Kim HL,Lim WH,Seo JB,Kim SH,Zo JH,Kim MA

doi

10.1097/HJH.0000000000002113

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

1966-1973

issue

eissn

0263-6352

issn

1473-5598

journal_volume

pub_type

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Association between invasively measured aortic pulse pressure and orthostatic hypotension in patients undergoing invasive coronary angiography.