Rise and fall in orthostatic BP tied to elevated PWV

An increase and a decrease in orthostatic blood pressure (BP) both correlate with greater pulse wave velocity (PWV), according to a study.

The authors sought to determine whether the phenotype of orthostatic hypertension was associated with more pronounced vascular hypertension-mediated organ damage (HMOD) and whether this correlated with other cardiovascular (CV) risk factors.

Two hundred patients referred to a tertiary hypertension clinic were prospectively assessed for unattended seated automated office BP and the response to 1 min of upright posture. The authors then calculated the difference in BP after standing up and evaluated PWV as a marker of vascular HMOD.

They also examined routine clinical CV risk markers and the association between orthostatic BP changes and PWV using regression models.

Baseline characteristic and clinic CV risk factors were comparable between groups of orthostatic BP response. There was U-shaped association noted between PWV and orthostatic BP changes with elevated PWV in patients with either a drop or a rise in BP due to an upright posture.

This association persisted in regression models after adjusting for other CV risk factors, including 24-h ambulatory BP.

“Although standing BP is commonly measured in elderly hypertensive patients to exclude significant orthostatic hypotension, this simple measurement may provide an additional independent risk factor for vascular HMOD at any age,” the authors said.