Tags: Heart Disease | blood | pressure | drop | heart | risk

Blood Pressure Drop After Standing Boosts Heart Risks

By Nick Tate   |   Friday, 22 Nov 2013 03:45 PM

People who experience a sudden drop in blood pressure when they stand up are far more likely to have a common heart-rhythm problem, according to a new study led by Johns Hopkins researchers.

The study, published in the Public Library of Science journal PLOS ONE, suggests physicians check for heartbeat irregularities in individuals who experience the blood pressure drop when they stand after lying down — a condition known as orthostatic hypotension.

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"We hope our research will sensitize physicians to a possible link between [the two conditions] and that they will go the extra step to see if something more serious is going on when patients experience rapid blood pressure fluctuations," said lead researcher Sunil K. Agarwal, M.D., a fellow in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. "We want this on their radar screens."

For the study, the researchers followed 12,071 men and women from 1987 to 1989. Five percent were diagnosed with a rapid drop in blood pressure when going from lying down to standing up. About 12 percent of the study participants developed atrial fibrillation over the course of the study.

After accounting for factors such as race, age, gender and other common risk factors for the arrhythmia, the researchers determined those with blood pressure drops after standing were 40 percent more likely to develop an irregular heartbeat.

A simple, inexpensive doctor's office test can check for the condition, but the researchers noted it does not generally need treatment. They also said atrial fibrillation is often present without causing noticeable symptoms.

Atrial fibrillation is the most common type of arrhythmia, or problem with the rate or rhythm of the heart. During an arrhythmia, the heart can beat too fast, too slow or with an irregular rhythm.

It affects approximately 3 million people in North America. Blood thinners have been shown to dramatically reduce stroke risk in these patients by more than half, but many don't take the medication because they are unaware they have the condition.

"We need more research into whether there is any sort of causal relationship between orthostatic hypotension and atrial fibrillation, or whether it is simply a marker of dysfunction of autonomic nervous system or generally poor health," said Dr. Agarwal.
This study was funded, in part, by the National Institutes of Health.

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