{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:16:55Z","timestamp":1785410215826,"version":"3.56.0"},"reference-count":76,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T00:00:00Z","timestamp":1680566400000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["640580"],"award-info":[{"award-number":["640580"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018270","name":"Health Service Executive","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018270","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"publisher","award":["203930\/B\/16\/Z"],"award-info":[{"award-number":["203930\/B\/16\/Z"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Irish Clinical Academic Training (ICAT) Programme"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and purpose<\/jats:title>\n                  <jats:p>Management of antihypertensive therapy is challenging in patients with symptomatic orthostatic hypotension, a population often excluded from randomised controlled trials of antihypertensive therapy. In this systematic review and meta-analysis, we sought to determine whether the association of antihypertensive therapy and adverse events (e.g. falls, syncope), differed among trials that included or excluded patients with orthostatic hypotension.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a systematic review and meta-analysis of randomised controlled trials comparing blood pressure lowering medications to placebo, or different blood pressure targets on falls or syncope outcomes and cardiovascular events. A random-effects meta-analysis was used to estimate a pooled treatment-effect overall in subgroups of trials that excluded patients with orthostatic hypotension and trials that did not exclude patients with orthostatic hypotension, and tested P for interaction. The primary outcome was fall events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>46 trials were included, of which 18 trials excluded orthostatic hypotension and 28 trials did not. The incidence of hypotension was significantly lower in trials that excluded participants with orthostatic hypotension (1.3% versus 6.2%, P\u2009&amp;lt;\u20090.001) but not incidences of falls (4.8% versus 8.8%; P\u2009=\u20090.40) or syncope (1.5% versus 1.8%; P\u2009=\u20090.67). Antihypertensive therapy was not associated with an increased risk of falls in trials that excluded (OR 1.00, 95% CI; 0.89\u20131.13) or included (OR 1.02, 95% CI; 0.88\u20131.18) participants with orthostatic hypotension (P for interaction\u2009=\u20090.90).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The exclusion of patients with orthostatic hypotension does not appear to affect the relative risk estimates for falls and syncope in antihypertensive trials.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afad044","type":"journal-article","created":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T13:32:33Z","timestamp":1680615153000},"source":"Crossref","is-referenced-by-count":7,"title":["Randomised controlled trials of antihypertensive therapy: does exclusion of orthostatic hypotension alter treatment effect? A systematic review and meta-analysis"],"prefix":"10.1093","volume":"52","author":[{"given":"Catriona","family":"Reddin","sequence":"first","affiliation":[{"name":"National University of Ireland Galway HRB\u2014Clinical Research Facility, , Galway D02 V583 , Ireland"},{"name":"Galway University Hospital , Newcastle Road, Galway H91 T861 , Ireland"},{"name":"Wellcome Trust\u2014HRB, Irish Clinical Academic Training , London NW1 2BE , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Murphy","sequence":"additional","affiliation":[{"name":"National University of Ireland Galway HRB\u2014Clinical Research Facility, , Galway D02 V583 , Ireland"},{"name":"Galway University Hospital , Newcastle Road, Galway H91 T861 , Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caoimhe","family":"Hanrahan","sequence":"additional","affiliation":[{"name":"National University of Ireland Galway HRB\u2014Clinical Research Facility, , Galway D02 V583 , Ireland"},{"name":"Galway University Hospital , Newcastle Road, Galway H91 T861 , Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Loughlin","sequence":"additional","affiliation":[{"name":"National University of Ireland Galway HRB\u2014Clinical Research Facility, , Galway D02 V583 , Ireland"},{"name":"Galway University Hospital , Newcastle Road, Galway H91 T861 , Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ferguson","sequence":"additional","affiliation":[{"name":"National University of Ireland Galway HRB\u2014Clinical Research Facility, , Galway D02 V583 , Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor","family":"Judge","sequence":"additional","affiliation":[{"name":"National University of Ireland Galway HRB\u2014Clinical Research Facility, , Galway D02 V583 , Ireland"},{"name":"Galway University Hospital , Newcastle Road, Galway H91 T861 , Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruairi","family":"Waters","sequence":"additional","affiliation":[{"name":"National University of Ireland Galway HRB\u2014Clinical Research Facility, , Galway D02 V583 , Ireland"},{"name":"Galway University Hospital , Newcastle Road, Galway H91 T861 , Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Canavan","sequence":"additional","affiliation":[{"name":"National University of Ireland Galway HRB\u2014Clinical Research Facility, , Galway D02 V583 , Ireland"},{"name":"Galway University Hospital , Newcastle Road, Galway H91 T861 , Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose Anne","family":"Kenny","sequence":"additional","affiliation":[{"name":"Mercer's Institute for Successful Ageing (MISA), St James's Hospital , Dublin D08 X9HD , UK"},{"name":"Trinity College Dublin Department of Medical Gerontology, , Dublin 2 D02 PN40 , 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