Does Intensive Blood Pressure Treatment Cause Orthostatic Hypotension?

Trial evidence suggests that intensive blood pressure (BP) treatment goals in high-risk hypertensive patients improve outcomes compared with less-intensive treatment goals (NEJM JW Gen Med Dec 15 2015 and N Engl J Med 2015; 373:2103). However, risk for orthostatic hypotension or other adverse effects of tight BP control (e.g., syncope) might limit application of intensive treatment goals, especially for older patients.

Researchers evaluated orthostatic hypotension incidence in a meta-analysis of five randomized, controlled trials (>18,000 patients) to compare the effects of intensive BP treatment goals versus less-intensive treatment goals. Orthostatic hypotension occurred significantly less frequently in patients who received intensive BP t…