School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Heart and Vascular Health Research Center, Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.
J Gerontol A Biol Sci Med Sci. 2024 Jul 1;79(7). doi: 10.1093/gerona/glae087.
The associations of age at orthostatic hypotension onset with incident myocardial infarction (MI), stroke, and dementia remain unknown. This study aimed to examine whether younger onset age of orthostatic hypotension was associated with higher risks of incident MI, stroke, and dementia.
Data were obtained from the UK Biobank. Information on the diagnosis of orthostatic hypotension, MI, stroke, and dementia was collected at baseline (2006-2010) and follow-ups (median = 13 years). The propensity score matching method and the Cox proportional hazard models were employed.
A total of 448 374 adults (mean age: 56.8 ± 8.1 years), of whom 3 795 had orthostatic hypotension, were included. orthostatic hypotension patients exhibited higher risks of developing MI, stroke, and dementia than non-orthostatic hypotension participants. Importantly, among orthostatic hypotension patients, younger onset age (per 10-year decrement) was significantly associated with high risks of MI (HR = 3.15, 95% CI: 2.54-3.90, p < .001), stroke (HR = 1.72, 95% CI: 1.33-2.23, p < .001), and dementia (HR = 1.26, 95% CI: 1.02-1.57, p = .034). After propensity score matching, orthostatic hypotension patients had significantly higher risks of MI, stroke, and dementia than matched controls among all onset age groups, and the HRs gradually increased with descending onset age.
Younger onset age of orthostatic hypotension was associated with higher risks of incident MI, stroke, and dementia, underscoring the necessity to pay additional attention to the cardiovascular health and neurocognitive status of individuals diagnosed with orthostatic hypotension at younger ages to attenuate subsequent risks of incident cardiovascular diseases and dementia.
直立性低血压发病年龄与心肌梗死（MI）、卒中和痴呆的关系尚不清楚。本研究旨在探讨直立性低血压发病年龄较早是否与更高的新发 MI、卒中和痴呆风险相关。
数据来自英国生物银行。在基线（2006-2010 年）和随访期间（中位数=13 年）收集了直立性低血压、MI、卒中和痴呆的诊断信息。采用倾向评分匹配法和 Cox 比例风险模型进行分析。
共纳入 448374 名成年人（平均年龄：56.8±8.1 岁），其中 3795 人患有直立性低血压。与非直立性低血压参与者相比，直立性低血压患者发生 MI、卒中和痴呆的风险更高。重要的是，在直立性低血压患者中，发病年龄较年轻（每减少 10 岁）与 MI（HR=3.15，95%CI：2.54-3.90，p<0.001）、卒中等风险显著相关（HR=1.72，95%CI：1.33-2.23，p<0.001）和痴呆（HR=1.26，95%CI：1.02-1.57，p=0.034）。在倾向评分匹配后，所有发病年龄组中，与匹配对照组相比，直立性低血压患者发生 MI、卒中和痴呆的风险显著更高，且随着发病年龄的降低，HR 逐渐升高。
直立性低血压发病年龄较早与新发 MI、卒中和痴呆风险较高相关，这表明需要更加关注年轻起病的直立性低血压患者的心血管健康和神经认知状况，以降低新发心血管疾病和痴呆的风险。
