Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis
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Date
2019-07
Journal Title
Journal ISSN
Volume Title
Publisher
Cardiological Society of India
Abstract
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.
Description
Keywords
Atrial fibrillation, Orthostatic hypotension
Citation
Prasitlumkum Narut, Kewcharoen Jakrin, Angsubhakorn Natthapon, Chongsathidkiet Pakawat, Rattanawong Pattara. Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis. Indian Heart Journal. 2019 Jul; 71(4): 320-327