TIA, stroke and orthostatic hypotension: a disease spectrum related to ageing vasculature?

C S Kwok, A C L Ong, J F Potter, A K Metcalf, P K Myint

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims
We sought to identify the determinants of orthostatic hypotension (OH) among patients referred to the transient ischaemic attack (TIA) clinic.

Methods
We conducted a retrospective analysis of prospectively collected data on patients who attended the TIA clinic in a UK hospital between January 2006 and September 2009. Each patient had their supine and standing or sitting blood pressure measured. Logistic regression was used to estimate the univariate and multivariate odds of OH for the subgroups of patients based on their diagnosis. A 10% significance level for the univariate analysis was used to identify variables in the multivariate model.

Results
A total of 3222 patients were studied of whom 1131 had a TIA, 665 a stroke and 1426 had other diagnoses. The prevalence of either systolic or diastolic OH in the TIA, stroke and patients with other diagnoses was similar being 22% (n = 251), 24% (n = 162) and 20% (n = 292), respectively. Multivariate analyses showed age, prior history of TIA, and diabetes were independently significantly associated with systolic OH alone or diastolic OH alone or either systolic or diastolic OH [ORs 1.03 (1.02–1.05); 1.56 (1.05–2.31); 1.65 (1.10–2.47), respectively]. Among the patients with the diagnosis of stroke, peripheral vascular disease (PVD) was significantly associated with increased odds of OH (3.56, 1.53–8.31), whereas male gender had a significantly lower odds of OH (0.61, 0.42–0.88). In patients with other diagnoses, age (1.04, 1.02–1.05) and diabetes (1.47, 1.04–2.09) were associated with OH, whereas male gender was (0.76, 0.58–1.00) not associated with OH.

Conclusion
Orthostatic hypotension is prevalent among patients presenting to TIA clinic. Previous history of vascular disease (prior TIA/stroke/PVD) appears to be a significant associate of OH in this patient population.
Original languageEnglish
Pages (from-to)705-713
Number of pages9
JournalInternational Journal of Clinical Practice
Volume68
Issue number6
Early online date22 Jan 2014
DOIs
Publication statusPublished - Jun 2014

Fingerprint

Orthostatic Hypotension
Transient Ischemic Attack
Stroke
Peripheral Vascular Diseases
Vascular Diseases
Hypotension
Multivariate Analysis
Logistic Models
Blood Pressure

Cite this

TIA, stroke and orthostatic hypotension : a disease spectrum related to ageing vasculature? / Kwok, C S; Ong, A C L; Potter, J F; Metcalf, A K; Myint, P K.

In: International Journal of Clinical Practice, Vol. 68, No. 6, 06.2014, p. 705-713.

Research output: Contribution to journalArticle

Kwok, C S ; Ong, A C L ; Potter, J F ; Metcalf, A K ; Myint, P K. / TIA, stroke and orthostatic hypotension : a disease spectrum related to ageing vasculature?. In: International Journal of Clinical Practice. 2014 ; Vol. 68, No. 6. pp. 705-713.
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title = "TIA, stroke and orthostatic hypotension: a disease spectrum related to ageing vasculature?",
abstract = "AimsWe sought to identify the determinants of orthostatic hypotension (OH) among patients referred to the transient ischaemic attack (TIA) clinic.MethodsWe conducted a retrospective analysis of prospectively collected data on patients who attended the TIA clinic in a UK hospital between January 2006 and September 2009. Each patient had their supine and standing or sitting blood pressure measured. Logistic regression was used to estimate the univariate and multivariate odds of OH for the subgroups of patients based on their diagnosis. A 10{\%} significance level for the univariate analysis was used to identify variables in the multivariate model.ResultsA total of 3222 patients were studied of whom 1131 had a TIA, 665 a stroke and 1426 had other diagnoses. The prevalence of either systolic or diastolic OH in the TIA, stroke and patients with other diagnoses was similar being 22{\%} (n = 251), 24{\%} (n = 162) and 20{\%} (n = 292), respectively. Multivariate analyses showed age, prior history of TIA, and diabetes were independently significantly associated with systolic OH alone or diastolic OH alone or either systolic or diastolic OH [ORs 1.03 (1.02–1.05); 1.56 (1.05–2.31); 1.65 (1.10–2.47), respectively]. Among the patients with the diagnosis of stroke, peripheral vascular disease (PVD) was significantly associated with increased odds of OH (3.56, 1.53–8.31), whereas male gender had a significantly lower odds of OH (0.61, 0.42–0.88). In patients with other diagnoses, age (1.04, 1.02–1.05) and diabetes (1.47, 1.04–2.09) were associated with OH, whereas male gender was (0.76, 0.58–1.00) not associated with OH.ConclusionOrthostatic hypotension is prevalent among patients presenting to TIA clinic. Previous history of vascular disease (prior TIA/stroke/PVD) appears to be a significant associate of OH in this patient population.",
author = "Kwok, {C S} and Ong, {A C L} and Potter, {J F} and Metcalf, {A K} and Myint, {P K}",
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TY - JOUR

T1 - TIA, stroke and orthostatic hypotension

T2 - a disease spectrum related to ageing vasculature?

AU - Kwok, C S

AU - Ong, A C L

AU - Potter, J F

AU - Metcalf, A K

AU - Myint, P K

N1 - © 2014 John Wiley & Sons Ltd.

PY - 2014/6

Y1 - 2014/6

N2 - AimsWe sought to identify the determinants of orthostatic hypotension (OH) among patients referred to the transient ischaemic attack (TIA) clinic.MethodsWe conducted a retrospective analysis of prospectively collected data on patients who attended the TIA clinic in a UK hospital between January 2006 and September 2009. Each patient had their supine and standing or sitting blood pressure measured. Logistic regression was used to estimate the univariate and multivariate odds of OH for the subgroups of patients based on their diagnosis. A 10% significance level for the univariate analysis was used to identify variables in the multivariate model.ResultsA total of 3222 patients were studied of whom 1131 had a TIA, 665 a stroke and 1426 had other diagnoses. The prevalence of either systolic or diastolic OH in the TIA, stroke and patients with other diagnoses was similar being 22% (n = 251), 24% (n = 162) and 20% (n = 292), respectively. Multivariate analyses showed age, prior history of TIA, and diabetes were independently significantly associated with systolic OH alone or diastolic OH alone or either systolic or diastolic OH [ORs 1.03 (1.02–1.05); 1.56 (1.05–2.31); 1.65 (1.10–2.47), respectively]. Among the patients with the diagnosis of stroke, peripheral vascular disease (PVD) was significantly associated with increased odds of OH (3.56, 1.53–8.31), whereas male gender had a significantly lower odds of OH (0.61, 0.42–0.88). In patients with other diagnoses, age (1.04, 1.02–1.05) and diabetes (1.47, 1.04–2.09) were associated with OH, whereas male gender was (0.76, 0.58–1.00) not associated with OH.ConclusionOrthostatic hypotension is prevalent among patients presenting to TIA clinic. Previous history of vascular disease (prior TIA/stroke/PVD) appears to be a significant associate of OH in this patient population.

AB - AimsWe sought to identify the determinants of orthostatic hypotension (OH) among patients referred to the transient ischaemic attack (TIA) clinic.MethodsWe conducted a retrospective analysis of prospectively collected data on patients who attended the TIA clinic in a UK hospital between January 2006 and September 2009. Each patient had their supine and standing or sitting blood pressure measured. Logistic regression was used to estimate the univariate and multivariate odds of OH for the subgroups of patients based on their diagnosis. A 10% significance level for the univariate analysis was used to identify variables in the multivariate model.ResultsA total of 3222 patients were studied of whom 1131 had a TIA, 665 a stroke and 1426 had other diagnoses. The prevalence of either systolic or diastolic OH in the TIA, stroke and patients with other diagnoses was similar being 22% (n = 251), 24% (n = 162) and 20% (n = 292), respectively. Multivariate analyses showed age, prior history of TIA, and diabetes were independently significantly associated with systolic OH alone or diastolic OH alone or either systolic or diastolic OH [ORs 1.03 (1.02–1.05); 1.56 (1.05–2.31); 1.65 (1.10–2.47), respectively]. Among the patients with the diagnosis of stroke, peripheral vascular disease (PVD) was significantly associated with increased odds of OH (3.56, 1.53–8.31), whereas male gender had a significantly lower odds of OH (0.61, 0.42–0.88). In patients with other diagnoses, age (1.04, 1.02–1.05) and diabetes (1.47, 1.04–2.09) were associated with OH, whereas male gender was (0.76, 0.58–1.00) not associated with OH.ConclusionOrthostatic hypotension is prevalent among patients presenting to TIA clinic. Previous history of vascular disease (prior TIA/stroke/PVD) appears to be a significant associate of OH in this patient population.

U2 - 10.1111/ijcp.12373

DO - 10.1111/ijcp.12373

M3 - Article

C2 - 24447402

VL - 68

SP - 705

EP - 713

JO - International Journal of Clinical Practice

JF - International Journal of Clinical Practice

SN - 1368-5031

IS - 6

ER -