SynthesisAnnals of internal medicine2021
Effects of Intensive Blood Pressure Treatment on Orthostatic Hypotension : A Systematic Review and Individual Participant-based Meta-analysis.
Synthesis in Annals of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 5 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- 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
- Comparative efficacy and safety of antidiabetic drugs for obese patients with knee osteoarthritis: a network meta-analysis of randomized controlled trials.Aging clinical and experimental research · 2025 · on this mapPooled it
- Effects of intensive blood pressure treatment on orthostatic hypertension: individual level meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Cardiovascular Disorders and Falls Among Older Adults: A Systematic Review and Meta-Analysis.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Pooled it
- Pooled it
- Associations of Hypertension and Orthostatic Hypotension With Subclinical Cardiovascular Disease.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Trial
- Evidence for Age Bias Contributing to Therapeutic Inertia in Blood Pressure Management: A Secondary Analysis of SPRINT.Hypertension (Dallas, Tex. : 1979) · 2023Trial
- Body Position and Orthostatic Hypotension in Hypertensive Adults: Results from the Syst-Eur Trial.Hypertension (Dallas, Tex. : 1979) · 2023Trial
- Effects of Vitamin D Supplementation on Orthostatic Hypotension: Results From the STURDY Trial.American journal of hypertension · 2022Trial
- The Association of Orthostatic Hypotension With Ambulatory Blood Pressure Phenotypes in SPRINT.American journal of hypertension · 2021Trial
- Timing of Orthostatic Blood Pressure Changes and Its Association With Orthostatic Symptoms and Falls at Very Old Ages: Findings From the ARIC Study.Hypertension (Dallas, Tex. : 1979) · 2026Article
- Harms of Continued Antihypertensives: An Overview of Reviews.Drugs & aging · 2026Review
- Updates in the 2025 AHA/ACC Hypertension Guideline.Current hypertension reports · 2026Review
- Personalizing prevention for healthy cardiovascular aging: Geriatric cardiology in the 2024-2025 hypertension and dyslipidemia guidelines.American journal of preventive cardiology · 2026Article
- Drug-Induced Orthostatic Hypotension in UK Primary Care: A Self-Controlled Case Series Study.Clinical epidemiology · 2026Article
- From woozy to well: a primary care approach to orthostatic hypotension.Singapore medical journal · 2025Article
- Supine hypertension and cardiovascular disease: controversies and advances.Future cardiology · 2025Review
- Practitioners' views on the measurement and management of postural hypotension in general practice: a qualitative inquiry.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- A scoping review of neuromodulation techniques for controlling blood pressure: what are the ups and downs to this approach?Bioelectronic medicine · 2025Review
- Antihypertensive Drugs and Dental Caries Risk: A Drug-Target Mendelian Randomization Analysis.International journal of genomics · 2025Article
Corrections and comments
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Authors and funding
20 authors at 13 institutions in 4 countries.
Funding
Abstract
backgroundAlthough intensive blood pressure (BP)-lowering treatment reduces risk for cardiovascular disease, there are concerns that it might cause orthostatic hypotension (OH). PURPOSE: To examine the effects of intensive BP-lowering treatment on OH in hypertensive adults. DATA SOURCES: MEDLINE, EMBASE, and Cochrane CENTRAL from inception through 7 October 2019, without language restrictions. STUDY SELECTION: Randomized trials of BP pharmacologic treatment (more intensive BP goal or active agent) that involved more than 500 adults with hypertension or elevated BP and that were 6 months or longer in duration. Trial comparisons were groups assigned to either less intensive BP goals or placebo, and the outcome was measured OH, defined as a decrease of 20 mm Hg or more in systolic BP or 10 mm Hg or more in diastolic BP after changing position from seated to standing. DATA EXTRACTION: 2 investigators independently abstracted articles and rated risk of bias. DATA SYNTHESIS: 5 trials examined BP treatment goals, and 4 examined active agents versus placebo. Trials examining BP treatment goals included 18 466 participants with 127 882 follow-up visits. Trials were open-label, with minimal heterogeneity of effects across trials. Intensive BP treatment lowered risk for OH (odds ratio, 0.93 [95% CI, 0.86 to 0.99]). Effects did not differ by prerandomization OH ( LIMITATIONS: Assessments of OH were done while participants were seated (not supine) and did not include the first minute after standing. Data on falls and syncope were not available.
conclusionIntensive BP-lowering treatment decreases risk for OH. Orthostatic hypotension, before or in the setting of more intensive BP treatment, should not be viewed as a reason to avoid or de-escalate treatment for hypertension. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute, National Institutes of Health. (PROSPERO: CRD42020153753).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.