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Title: Orthostatic hypotension is associated with new-onset atrial fibrillation: Systemic review and meta-analysis
Authors: Narut Prasitlumkum
Jakrin Kewcharoen
Natthapon Angsubhakorn
Pakawat Chongsathidkiet
Pattara Rattanawong
Duke University Medical Center
University of Minnesota Twin Cities
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
University of Hawaii at Manoa
Keywords: Medicine
Issue Date: 1-Jul-2019
Citation: Indian Heart Journal. Vol.71, No.4 (2019), 320-327
Abstract: © 2019 Cardiological Society of India 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.
ISSN: 22133763
Appears in Collections:Scopus 2019

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