Orthostatic hypertension is an accessible, low-cost marker of cardiovascular risk
Bibliographic record
Abstract
Orthostatic hypertension (OHT) is understudied and underrecognized.In fact, OHT is not even defined or commented upon in international hypertension guidelines. 1,2While no specific blood pressure (BP) threshold is consistently used, studies examining OHT typically define OHT as an increase in systolic blood pressure (SBP) 20 mmHg and/or an increase in diastolic blood pressure (DBP) 10 mmHg when moving from a supine to upright position. [3][4]4][5] The mechanisms underlying OHT are thought to include baroreceptor reflex abnormalities, exaggerated adrenergic response to changes in cardiac loading conditions (i.e.decreased preload in the setting of vascular pooling), and endothelial dysfunction. 3Given the possible mechanistic connections between OHT and cardiovascular disease (CVD), a better understanding of its clinical implications is important.In this issue, Pasdar et al. 6 demonstrate a consistent association between OHT and key cardiovascular/cerebrovascular outcomes through a systematic review and meta-analysis of available data.Studies eligible for inclusion were observational (prospective and cross-sectional) and interventional studies, which assessed the association between systolic and/or diastolic OHT and at least one of the following outcomes: allcause mortality, incident coronary heart disease (CHD), heart failure (HF), stroke, falls, or neurocognitive decline.Studies were limited to adults and were conducted in inpatient as well as outpatient settings -both community-dwelling adults and those living in nursing/residential facilities were included.For this analysis, 378 studies were identified with 20 ultimately included, comprising 61 669 participants (47% women) from 12 countries.Of the included studies, one was a post hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) and the remainder were observational.Participant characteristics varied, but most studies focused on older adults (80% of studies in adults >40 years), and only one excluded individuals with baseline hypertension.Study quality was assessed using the Newcastle-Ottawa Scale, and studies that the authors identified as relatively homogeneousbased on the study population, design, outcome, and context-were pooled for analysis.Analyses were considered adjusted if they at minimum adjusted for age (although all analyses adjusted for additional factors).Random-effects meta-analyses were conducted using the Cochrane Collaboration statistical software package.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.006 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".