{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:40:02Z","timestamp":1790617202187,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1998,11,24]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Population-based data are unavailable concerning the predictive value of orthostatic hypotension on mortality in ambulatory elderly patients, particularly minority groups.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014With the use of data from the Honolulu Heart Program\u2019s fourth examination (1991 to 1993), orthostatic hypotension was assessed in relation to subsequent 4-year all-cause mortality among a cohort of 3522 Japanese American men 71 to 93 years old. Blood pressure was measured in the supine position and after 3 minutes of standing, with the use of standardized methods. Orthostatic hypotension was defined as a drop in systolic blood pressure (SBP) of \u226520 mm Hg or in diastolic blood pressure of \u226510 mm Hg. Overall prevalence of orthostatic hypotension was 6.9% and increased with age. There was a total of 473 deaths in the cohort over 4 years; of those who died, 52 had orthostatic hypotension. Four-year age-adjusted mortality rates in those with and without orthostatic hypotension were 56.6 and 38.6 per 1000 person-years, respectively. With the use of Cox proportional hazards models, after adjustment for age, smoking, diabetes mellitus, body mass index, physical activity, seated systolic blood pressure, antihypertensive medications, hematocrit, alcohol intake, and prevalent stroke, coronary heart disease and cancer, orthostatic hypotension was a significant independent predictor of 4-year all-cause mortality (relative risk 1.64, 95% CI 1.19 to 2.26). There was a significant linear association between change in systolic blood pressure from supine position to standing and 4-year mortality rates (test for linear trend,\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001), suggesting a dose-response relation.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Orthostatic hypotension is relatively uncommon, may be a marker for physical frailty, and is a significant independent predictor of 4-year all-cause mortality in this cohort of elderly ambulatory men.\n          <\/jats:p>","DOI":"10.1161\/01.cir.98.21.2290","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:41:02Z","timestamp":1339461662000},"page":"2290-2295","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":376,"title":["Orthostatic Hypotension Predicts Mortality in Elderly Men"],"prefix":"10.1161","volume":"98","author":[{"given":"Kamal H.","family":"Masaki","sequence":"first","affiliation":[{"name":"From the Honolulu Heart Program, Kuakini Medical Center, Honolulu (K.H.M., I.J.S., D.C., J.D.C.); the John A. Burns School of Medicine, University of Hawaii, Divisions of Clinical Epidemiology and Geriatrics, Honolulu (K.H.M., I.J.S., J.D.C.); the Honolulu Epidemiology Research Unit, Division of Epidemiology and Clinical Applications, the National Heart, Lung, and Blood Institute, Honolulu, Hawaii (C.M.B., D.S.S.); and the Epidemiology, Demography, and Biometry Program, the National Institute on..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irwin J.","family":"Schatz","sequence":"additional","affiliation":[{"name":"From the Honolulu Heart Program, Kuakini Medical Center, Honolulu (K.H.M., I.J.S., D.C., J.D.C.); the John A. Burns School of Medicine, University of Hawaii, Divisions of Clinical Epidemiology and Geriatrics, Honolulu (K.H.M., I.J.S., J.D.C.); the Honolulu Epidemiology Research Unit, Division of Epidemiology and Clinical Applications, the National Heart, Lung, and Blood Institute, Honolulu, Hawaii (C.M.B., D.S.S.); and the Epidemiology, Demography, and Biometry Program, the National Institute on..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecil M.","family":"Burchfiel","sequence":"additional","affiliation":[{"name":"From the Honolulu Heart Program, Kuakini Medical Center, Honolulu (K.H.M., I.J.S., D.C., J.D.C.); the John A. Burns School of Medicine, University of Hawaii, Divisions of Clinical Epidemiology and Geriatrics, Honolulu (K.H.M., I.J.S., J.D.C.); the Honolulu Epidemiology Research Unit, Division of Epidemiology and Clinical Applications, the National Heart, Lung, and Blood Institute, Honolulu, Hawaii (C.M.B., D.S.S.); and the Epidemiology, Demography, and Biometry Program, the National Institute on..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan S.","family":"Sharp","sequence":"additional","affiliation":[{"name":"From the Honolulu Heart Program, Kuakini Medical Center, Honolulu (K.H.M., I.J.S., D.C., J.D.C.); the John A. Burns School of Medicine, University of Hawaii, Divisions of Clinical Epidemiology and Geriatrics, Honolulu (K.H.M., I.J.S., J.D.C.); the Honolulu Epidemiology Research Unit, Division of Epidemiology and Clinical Applications, the National Heart, Lung, and Blood Institute, Honolulu, Hawaii (C.M.B., D.S.S.); and the Epidemiology, Demography, and Biometry Program, the National Institute on..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darryl","family":"Chiu","sequence":"additional","affiliation":[{"name":"From the Honolulu Heart Program, Kuakini Medical Center, Honolulu (K.H.M., I.J.S., D.C., J.D.C.); the John A. Burns School of Medicine, University of Hawaii, Divisions of Clinical Epidemiology and Geriatrics, Honolulu (K.H.M., I.J.S., J.D.C.); the Honolulu Epidemiology Research Unit, Division of Epidemiology and Clinical Applications, the National Heart, Lung, and Blood Institute, Honolulu, Hawaii (C.M.B., D.S.S.); and the Epidemiology, Demography, and Biometry Program, the National Institute on..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Foley","sequence":"additional","affiliation":[{"name":"From the Honolulu Heart Program, Kuakini Medical Center, Honolulu (K.H.M., I.J.S., D.C., J.D.C.); the John A. Burns School of Medicine, University of Hawaii, Divisions of Clinical Epidemiology and Geriatrics, Honolulu (K.H.M., I.J.S., J.D.C.); the Honolulu Epidemiology Research Unit, Division of Epidemiology and Clinical Applications, the National Heart, Lung, and Blood Institute, Honolulu, Hawaii (C.M.B., D.S.S.); and the Epidemiology, Demography, and Biometry Program, the National Institute on..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. David","family":"Curb","sequence":"additional","affiliation":[{"name":"From the Honolulu Heart Program, Kuakini Medical Center, Honolulu (K.H.M., I.J.S., D.C., J.D.C.); the John A. Burns School of Medicine, University of Hawaii, Divisions of Clinical Epidemiology and Geriatrics, Honolulu (K.H.M., I.J.S., J.D.C.); the Honolulu Epidemiology Research Unit, Division of Epidemiology and Clinical Applications, the National Heart, Lung, and Blood Institute, Honolulu, Hawaii (C.M.B., D.S.S.); and the Epidemiology, Demography, and Biometry Program, the National Institute on..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(91)90012-M"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.35.5.527"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)30602-2"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1991.tb02869.x"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.19.6.508"},{"key":"e_1_3_2_6_2","unstructured":"Schatz IJ. Orthostatic Hypotension. Philadelphia Pa: FA Davis Co; 1986:16\u201317."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1984.00350160129021"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198910053211407"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1990.tb03469.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","unstructured":"Masuo K Mikami H Ogihara T. The frequency of orthostatic hypotension in elderly patients with essential hypertension isolated systolic hypertension and borderline hypertension. J Hypertens. 1993;11(suppl 5):S306\u2013S307.","DOI":"10.1097\/00004872-199312050-00132"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.81.4.1969334"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1991.tb03593.x"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1838(96)90001-6"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(70)90022-6"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113787"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(96)00103-2"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.19.6.587"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1979.03630450011006"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/141.4.360"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.153.2.8564136"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1995.tb05525.x"},{"key":"e_1_3_2_22_2","unstructured":"Curb JD. Mortality. In: Kagan A ed. The Honolulu Heart Program: An Epidemiological Study of Coronary Heart Disease and Stroke. Amsterdam Netherlands: Harwood Academic Publishers; 1996:127\u2013134."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114532"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.75.2.3802437"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1995.00430090067008"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/45.5.S206"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a060143"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(97)89517-4"},{"key":"e_1_3_2_29_2","doi-asserted-by":"crossref","unstructured":"Lipsitz LA Pluchino FC Wei JY Rowe JW. Syncope in institutionalized elderly the impact of multiple pathological conditions and situational stress. J Chron Dis 1986; 39:619\u2013630.","DOI":"10.1016\/0021-9681(86)90187-6"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1995.tb07016.x"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1987.03400110093033"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1992.00400170130024"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.70.830.878"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.3109\/03790798709166193"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0690(18)30494-4"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03324099"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.98.21.2290","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T16:53:36Z","timestamp":1715532816000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.98.21.2290"}},"subtitle":["The Honolulu Heart Program"],"short-title":[],"issued":{"date-parts":[[1998,11,24]]},"references-count":36,"journal-issue":{"issue":"21","published-print":{"date-parts":[[1998,11,24]]}},"alternative-id":["10.1161\/01.CIR.98.21.2290"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.98.21.2290","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,11,24]]},"assertion":[{"value":"1998-03-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-08-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-11-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}