Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.
The First Affiliated Hospital of Anhui Medical University, Hefei, China.
J Clin Hypertens (Greenwich). 2019 Aug;21(8):1221-1227. doi: 10.1111/jch.13613. Epub 2019 Jul 10.
The relationships between orthostatic hypotension (OH) and some kinds of cardiovascular disease are inconsistent among studies. This updated meta-analysis was conducted in hopes of producing progress on this topic. A systematic database search was performed in electronic databases, including the Chinese Biomedical Database (CBM), PubMed, Web of Science, and the Cochrane Library. Summary hazard ratio (HR) estimates with 95% confidence intervals (CIs) were calculated by a random-effects model. Statistical heterogeneity was assessed with Cochran's Q test and the I statistic. From 1462 potentially eligible records, 15 studies met the inclusion criteria. Subjects with OH had a high risk of heart failure (HF) and atrial fibrillation (AF) (pooled HR 1.34, 95% CI 1.17-1.52, P < 0.001 and pooled HR 1.51, 95% CI 1.28-1.79, P < 0.001, respectively). This meta-analysis also showed significant associations between OH and the risks of developing coronary heart disease (CHD) (pooled HR 1.44, 95% CI 1.18-1.75, P < 0.001) and myocardial infarction (MI) (pooled HR 1.52, 95% CI 1.12-2.06, P = 0.008). Our study suggests that OH is positively associated with high risks of HF and AF. Moreover, it may be related to high risks of CHD and MI.
体位性低血压（OH）与某些心血管疾病之间的关系在不同的研究中并不一致。本次更新的荟萃分析旨在对此问题取得进展。我们在电子数据库中进行了系统的数据库搜索，包括中国生物医学数据库（CBM）、PubMed、Web of Science 和 Cochrane Library。通过随机效应模型计算了汇总风险比（HR）估计值及其 95％置信区间（CI）。采用 Cochran's Q 检验和 I 统计量评估统计异质性。从 1462 篇潜在的合格记录中，有 15 项研究符合纳入标准。OH 患者发生心力衰竭（HF）和心房颤动（AF）的风险较高（汇总 HR 1.34，95％CI 1.17-1.52，P<0.001 和汇总 HR 1.51，95％CI 1.28-1.79，P<0.001）。荟萃分析还表明，OH 与发生冠心病（CHD）（汇总 HR 1.44，95％CI 1.18-1.75，P<0.001）和心肌梗死（MI）（汇总 HR 1.52，95％CI 1.12-2.06，P=0.008）的风险之间存在显著关联。本研究表明，OH 与 HF 和 AF 的高风险呈正相关。此外，它可能与 CHD 和 MI 的高风险有关。
