An US prospective cohort study revealed that orthostatic hypotension (OH) in midlife was independently associated with incident dementia and ischemic stroke. The study included 11,709 participants without a history of coronary heart disease or stroke at the baseline examination (1987–1989, mean age 54). OH was defined as a drop in systolic blood pressure (BP) of at least 20 mm Hg or a drop in diastolic BP of at least 10 mm Hg on standing. Cox regression and linear mixed model was used for analysis of associations of OH with dementia, ischemic stroke and cognitive function. Over ≈25 years, 1,068 participants developed dementia and 842 had an ischemic stroke. Compared to persons without OH at baseline, those with OH had a higher risk of dementia (hazard ratio [HR] 1.54) and ischemic stroke (HR 2.08). Persons with OH had greater, although nonsignificant, cognitive decline over 20 years. Ischemic stroke accounted for a small part of the excess risk of dementia in the association with OH. OH might be the early sign of a neurodegenerative disorder. Source: http://n.neurology.org/
