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To assess the impact of systolic orthostatic hypertension (SOHT) on all cause-mortality.

Design and method:

1176 subjects over 18 years were included in this ambispective study. The subjects were from Cantabria, Spain. Blood pressure (BP) was measured in a sitting position, and after three minutes of standing, from May 2002 to February 2005. Mean follow-up was 9.4 ± 2 years. Data about age, gender, current smoker, alcohol, diabetes, body mass index (BMI), hypercholesterolemia, sedentary lifestyle, systolic and diastolic basal BP, antihypertensive treatment, basal heart rate, heart disease, arrhythmia, cerebrovascular disease, peripheral artery disease and headache were recorded. SOHT was defined as an increase of systolic BP at least 20 mmHg from sitting to standing position at three minutes after standing.


The mean age was 48.5 ± 18.5 years (range: 18–98 years). 3.1 % (n = 37) individuals had SOHT. Those subjects with SOHT were older (p < 0.001), had significantly more diabetes (p = 0.028), antihypertensive treatment (p < 0.001), heart disease (p = 0.002) and arrhythmia (p = 0.021). BMI (p = 0.002) and systolic BP (p = 0.049) were also higher in this group. The mortality rate was 37.8%. A multivariate Cox proportional hazard model analysis demonstrated that current smoker (HR: 2.91; p = 0.002), peripheral artery disease (HR: 2.67; p = 0.009), arrhythmia (HR: 2.39; p = 0.002) and age (HR: 1.13; p < 0.001) were independent risk factors of all-cause mortality. SOHT at three minutes also was a predictor of all-cause mortality in the adjusted model (HR: 2.31; CI 95 %: 1.14–4.68; p = 0.020).


SOHT is associated with all-cause mortality. The results of this study suggest that it could be useful to measure SOHT in the routine physical examination of patients.

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