ArticlePloS one2016
Single Agent Antihypertensive Therapy and Orthostatic Blood Pressure Behaviour in Older Adults Using Beat-to-Beat Measurements: The Irish Longitudinal Study on Ageing.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Review of Clinical Trial and Meta-Analyses of BP Treatment Strategies for Patients with Orthostatic Hypotension: Blood Pressure Management in Patients with Hypertension and Orthostatic Hypotension.Current hypertension reports · 2026Pooled it
- Drug-induced orthostatic hypotension: A systematic review and meta-analysis of randomised controlled trials.PLoS medicine · 2021Pooled it
- Body Position and Orthostatic Hypotension in Hypertensive Adults: Results from the Syst-Eur Trial.Hypertension (Dallas, Tex. : 1979) · 2023Trial
- Effects of Antihypertensive Class on Falls, Syncope, and Orthostatic Hypotension in Older Adults: The ALLHAT Trial.Hypertension (Dallas, Tex. : 1979) · 2019Trial
- Blood Pressure Lowering With Nilvadipine in Patients With Mild-to-Moderate Alzheimer Disease Does Not Increase the Prevalence of Orthostatic Hypotension.Journal of the American Heart Association · 2019Trial
- Hypertension Treatment Effects on Orthostatic Hypotension and Its Relationship With Cardiovascular Disease.Hypertension (Dallas, Tex. : 1979) · 2018Trial
- Relating consequential falls to individual and combinations of prescription medication use in Swedish older adults.European journal of clinical pharmacology · 2026Article
- How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Drug-Induced Orthostatic Hypotension in UK Primary Care: A Self-Controlled Case Series Study.Clinical epidemiology · 2026Article
- Risk assessment of the top 50 drugs associated with drug-induced orthostatic hypotension: a disproportionality analysis of the FAERS and JADER databases.Scientific reports · 2025Article
- Misconceptions and Facts About Orthostatic Hypotension.The American journal of medicine · 2025Review
- Orthostatic Hypotension in Adults With Hypertension: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2024Review
- Management of Labile Blood Pressure due to COVID-19 Infection and Radiation Induced Baroreceptor Dysfunction.Kansas journal of medicine · 2023Article
- Variation in Mean Arterial Pressure Increases Falls Risk in Elderly Physically Frail and Prefrail Individuals Treated With Antihypertensive Medication.Hypertension (Dallas, Tex. : 1979) · 2022Article
- Impaired Stabilization of Orthostatic Cerebral Oxygenation Is Associated With Slower Gait Speed: Evidence From The Irish Longitudinal Study on Ageing.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022Article
- Feasibility of Diagnosing Initial Orthostatic Hypotension Using a Continuous Blood Pressure Device in Geriatric Rehabilitation Inpatients: RESORT.Gerontology · 2022Article
- Diagnostic criteria for initial orthostatic hypotension: a narrative review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Review
- Evaluation of Patients with Syncope in the Emergency Department: How to Adjust Pharmacological Therapy.Medicina (Kaunas, Lithuania) · 2021Review
- Drug-Related Orthostatic Hypotension: Beyond Anti-Hypertensive Medications.Drugs & aging · 2020Review
- Addressing Orthostatic Hypotension in Heart Failure: Pathophysiology, Clinical Implications and Perspectives.Journal of cardiovascular translational research · 2020Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImpaired blood pressure (BP) stabilisation after standing, defined using beat-to-beat measurements, has been shown to predict important health outcomes. We aimed to define the relationship between individual classes of antihypertensive agent and BP stabilisation among hypertensive older adults.
methodsCross-sectional analysis from The Irish Longitudinal Study on Ageing, a cohort study of Irish adults aged 50 years and over. Beat-to-beat BP was recorded in participants undergoing an active stand test. We defined grade 1 hypertension according to European Society of Cardiology criteria (systolic BP [SBP] 140-159 mmHg ± diastolic BP [DBP] 90-99 mmHg). Outcomes were: (i) initial orthostatic hypotension (IOH) (SBP drop ≥40 mmHg ± DBP drop ≥20 mmHg within 15 seconds [s] of standing accompanied by symptoms); (ii) sustained OH (SBP drop ≥20 mmHg ± DBP drop ≥10 mmHg from 60 to 110 s inclusive); (iii) impaired BP stabilisation (SBP drop ≥20 mmHg ± DBP drop ≥10 mmHg at any 10 s interval during the test). Outcomes were assessed using multivariable-adjusted logistic regression.
resultsA total of 536 hypertensive participants were receiving monotherapy with a renin-angiotensin-aldosterone-system inhibitor (n = 317, 59.1%), beta-blocker (n = 89, 16.6%), calcium channel blocker (n = 89, 16.6%) or diuretic (n = 41, 7.6%). A further 783 untreated participants met criteria for grade 1 hypertension. Beta-blockers were associated with increased odds of initial OH (OR 2.05, 95% CI 1.31-3.21) and sustained OH (OR 3.36, 95% CI 1.87-6.03) versus untreated grade 1 hypertension. Multivariable adjustment did not attenuate the results. Impaired BP stabilisation was evident at 20 s (OR 2.59, 95% CI 1.58-4.25) and persisted at 110 s (OR 2.90, 95% CI 1.64-5.11). No association was found between the other agents and any study outcome.
conclusionBeta-blocker monotherapy was associated with a >2-fold increased odds of initial OH and a >3-fold increased odds of sustained OH and impaired BP stabilisation, compared to untreated grade 1 hypertension. These findings support existing literature questioning the role of beta-blockers as first line agents for essential hypertension.
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