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Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis

INTRODUCTION: Orthostatic hypotension (OH) is common among elderly patients. Its presence may herald severe underlying comorbidities and be associated with a higher risk of mortality. Interestingly, recent studies suggest that OH is associated with new-onset atrial fibrillation (AF). However, a syst...

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Autores principales: Prasitlumkum, Narut, Kewcharoen, Jakrin, Angsubhakorn, Natthapon, Chongsathidkiet, Pakawat, Rattanawong, Pattara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890958/
https://www.ncbi.nlm.nih.gov/pubmed/31779860
http://dx.doi.org/10.1016/j.ihj.2019.07.009
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author Prasitlumkum, Narut
Kewcharoen, Jakrin
Angsubhakorn, Natthapon
Chongsathidkiet, Pakawat
Rattanawong, Pattara
author_facet Prasitlumkum, Narut
Kewcharoen, Jakrin
Angsubhakorn, Natthapon
Chongsathidkiet, Pakawat
Rattanawong, Pattara
author_sort Prasitlumkum, Narut
collection PubMed
description INTRODUCTION: Orthostatic hypotension (OH) is common among elderly patients. Its presence may herald severe underlying comorbidities and be associated with a higher risk of mortality. Interestingly, recent studies suggest that OH is associated with new-onset atrial fibrillation (AF). However, a systematic review and meta-analysis of the literature has not been performed. We assessed the association between AF and OH through a systematic review of the literature and a meta-analysis. METHODS: We comprehensively searched the databases of MEDLINE and EMBASE from inception to November 2018. Published prospective or retrospective cohort studies that compared new-onset AF between male patients with and without OH were included. Data from each study were combined using the random-effects, generic inverse-variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals. RESULTS: Four studies from October 2010 to March 2018 were included in the meta-analysis involving 76,963 subjects (of which 3318 were diagnosed with OH). The presence of OH was associated with new-onset AF (pooled risk ratio 1.48; 95% confidence interval [1.21, 1.81], p?< 0.001; I2 = 69.4%). In hypertensive patients, analysis revealed an association between OH and the occurrence of new-onset AF (OR 1.46; 95% CI [1.27, 1.68], p < 0.001 with I2 = 0). CONCLUSIONS: OH was associated with new-onset AF up to 1.5-fold compared with those subjects without OH. The interplay between OH and AF is likely bidirectional.
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spelling pubmed-68909582020-07-01 Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis Prasitlumkum, Narut Kewcharoen, Jakrin Angsubhakorn, Natthapon Chongsathidkiet, Pakawat Rattanawong, Pattara Indian Heart J Original Article INTRODUCTION: Orthostatic hypotension (OH) is common among elderly patients. Its presence may herald severe underlying comorbidities and be associated with a higher risk of mortality. Interestingly, recent studies suggest that OH is associated with new-onset atrial fibrillation (AF). However, a systematic review and meta-analysis of the literature has not been performed. We assessed the association between AF and OH through a systematic review of the literature and a meta-analysis. METHODS: We comprehensively searched the databases of MEDLINE and EMBASE from inception to November 2018. Published prospective or retrospective cohort studies that compared new-onset AF between male patients with and without OH were included. Data from each study were combined using the random-effects, generic inverse-variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals. RESULTS: Four studies from October 2010 to March 2018 were included in the meta-analysis involving 76,963 subjects (of which 3318 were diagnosed with OH). The presence of OH was associated with new-onset AF (pooled risk ratio 1.48; 95% confidence interval [1.21, 1.81], p?< 0.001; I2 = 69.4%). In hypertensive patients, analysis revealed an association between OH and the occurrence of new-onset AF (OR 1.46; 95% CI [1.27, 1.68], p < 0.001 with I2 = 0). CONCLUSIONS: OH was associated with new-onset AF up to 1.5-fold compared with those subjects without OH. The interplay between OH and AF is likely bidirectional. Elsevier 2019 2019-08-14 /pmc/articles/PMC6890958/ /pubmed/31779860 http://dx.doi.org/10.1016/j.ihj.2019.07.009 Text en © 2019 Cardiological Society of India. Published by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Prasitlumkum, Narut
Kewcharoen, Jakrin
Angsubhakorn, Natthapon
Chongsathidkiet, Pakawat
Rattanawong, Pattara
Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis
title Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis
title_full Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis
title_fullStr Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis
title_full_unstemmed Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis
title_short Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis
title_sort orthostatic hypotension is associated with new-onset atrial fibrillation: systemic review and meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890958/
https://www.ncbi.nlm.nih.gov/pubmed/31779860
http://dx.doi.org/10.1016/j.ihj.2019.07.009
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