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Orthostatic hypotension and vitamin D deficiency in older adults: systematic review and meta-analysis

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Abstract

Background

Over the latest years different studies have investigated the possible relationship between D deficiency and occurrence of orthostatic hypotension (OH), often reaching controversial results. We perform an update meta-analysis providing an update overview on the association between hypovitaminosis D and orthostatic hypotension (OH) in older adults.

Methods

Data extraction was independently performed by two authors and based upon predefined criteria. The meta-analysis was performed using a random-effects model. Statistical heterogeneity between groups was measured using the Higgins I2 statistic.

Results

Eight investigations enrolling 16.326 patients (mean age 75.5 years) met the inclusion criteria and were considered for the analysis. Patients with vitamin D deficiency were more likely to have OH compared to those without (OR: 1.36, 95% CI 1.14–1.63, p = 0.0001, I2 = 43.6%). A further sub-analysis, based on three studies, estimating the risk of OH in patients with hypovitaminosis D receiving antihypertensive treatment, did not reach the statistical significance (OR: 1.40, 95% CI 0.61–3.18, p = 0.418, I2 = 53.3%). Meta-regression performed using age (p = 0.12), BMI (p = 0.73) and gender (p = 0.62) as moderators did not reveal any statistical significance in influencing OH. Conversely, physical activity, Vitamin D supplementation and use of radioimmunoassay for the measurement of vitamin D serum levels showed a significant inverse relationship towards the risk of OH (Coeff.—0.09, p = 0.002, Coeff. − 0.12, p < 0.001 and Coeff. − 0.08, p = 0.03, respectively) among patients with hypovitaminosis D. A direct correlation between the administration of antihypertensive treatment and the risk of OH in older patients with low vitamin D level was observed (Coeff. 0.05, p < 0.001).

Conclusions

Hypovitaminosis D is significantly associated with OH in older adults and directly influence by the administration of antihypertensive drugs. Conversely, physical activity, vitamin D supplementation and use of radioimmunoassay as analytic method inversely correlated with the risk of OH in older patients.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Translational Medicine, Section of Internal and CardioRespiratory Medicine, University of Ferrara; Sant’Anna Hospital, 44100, Ferrara, Italy

    Marco Zuin, Gloria Brombo, Eleonora Capatti, Tommaso Romagnoli & Giovanni Zuliani

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  1. Marco Zuin
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  2. Gloria Brombo
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  3. Eleonora Capatti
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  4. Tommaso Romagnoli
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  5. Giovanni Zuliani
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Contributions

MZ and GZ designed the study. MZ, EC, TR and GZ designed the literature search and searched the articles. GB, TR and MZ contributed to the data extraction process. MZ and GZ analyzed the data. MZ and GB wrote the first draft of article. All the authors revised the article and approved the final version.

Corresponding author

Correspondence to Marco Zuin.

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Conflict of interest

None of the authors have conflicts of interest to declare.

Ethical approval

This is a review article and no human or animal participants were recruited to this study.

Human and animal rights

This is a review article. All data used were from published articles, which were following the ethical standards of the institutional review board/international ethics committee for each center and with the 1964 Helsinki Declaration and its later amendments.

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All data used in this article were from studies that had obtained the informed consent of all individual participants.

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Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 PRISMA Checklist (DOCX 29 KB)

40520_2021_1994_MOESM2_ESM.docx

Supplementary file2 Quality of the included studies assessed using the Newcastle–Ottawa quality assessment scale (NOS) (DOCX 17 KB)

40520_2021_1994_MOESM3_ESM.jpg

Supplementary file3 Funnel plot investigating the risk of orthostatic hypotension in patients with hypovitaminosis D receiving antihypertensive treatment (JPG 43 KB)

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Zuin, M., Brombo, G., Capatti, E. et al. Orthostatic hypotension and vitamin D deficiency in older adults: systematic review and meta-analysis. Aging Clin Exp Res 34, 951–958 (2022). https://doi.org/10.1007/s40520-021-01994-w

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  • DOI: https://doi.org/10.1007/s40520-021-01994-w

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