Table 2.

Summary of findings: Association orthostatic hypotension and lacunes.

Author, year	Study design	Participants	OH assessment	Outcome assessment	Statistical adjustment	Outcomes
Cui et al., 2020 24	Cross-sectional cohort	N = 663 Chinese participants (aged >=60) presenting at community centers.Mean ± SD age (yrs): NOH: 68.1 ± 5.5,1HOH: 69.1 ± 6.1, 2HOH: 69.2 ± 5.356.5% female32.3% one episode of OH14.6% two episodes of OH	Home measured OH (HOH), 3 consecutive days twice a day (morning before medication and after dinner). Measured in sitting position after 5 minutes, and 1 minute after standing up. Divided into 1 episode of HOH (1HOH), or ≥2 episodes of HOH (2HOH).	Imaging: 3 T MRI scanner, T2 and FLAIR images.Assessor: Experienced neuroradiologists, blinded to OH measurement.Lacunes: Presence of lacunes (≥1)	Adjusted for: Age, home SBP, smoking, LDL level, FPG, antihypertensive medication, anti-diabetes medication.	Statistically significant association between 2HOH and lacunes. Lacunes ≥1 (OR, 95%CI):1HOH 1.89 (0.89–3.08), 2HOH 5.36 (2.99–9.61)
Foster-Dingley et al., 2018 34	Cross-sectional cohort (baseline data from randomized controlled trial)	N = 214 Older participants (+75) from DANTE study, Leiden, the Netherlands, with mild cognitive impairment using antihypertensive medication. Without serious cardiovascular disease or dementia. Mean ± SD age (yrs): 81 ± 4.157% female49% with OH.	Five minutes seated, blood pressure measurement at 1 and 3 minutes after standing up.	Imaging: 3 T MRI scan, T2 and FLAIR imagesAssessor: Assessor unclear. All measurements were obtained blinded to participants’ demographic and clinical information.Lacunes: Presence of lacunes (≥1)	Adjusted for: Age, sex	No statistically significant association between OH and lacunes.Lacunes ≥ 1, OR (95%CI):1.16 (0.65–2.08)
Jacob et al., 2021 25	Cross-sectional cohort	N = 503 Community dwelling older adults from RUN-DMC study, Radboud University Nijmegen, The Netherlands, undergoing MRI. Aged between 50–80, visible SVD on MRI.Mean ± SD age (yrs): 65.5 ± 8.856.5% female9.1% with OH.	Five minutes supine, blood pressure measurement at 1 minute after standing up.	Imaging: 1.5 T MRI, T2 and flair imagingAssessor: Manually by two trained raters, blinded for clinical data. Lacunes: Presence of lacunes (≥1)	Adjusted for: age, sex, hypertension, hypercholesterolemia, OH inducing drugs.	No statistically significant association between OH and lacunes.Lacunes ≥1, OR (95%CI):1.88 (0.97–3.61)
Wiersinga et al., 2023 35	Cross-sectional cohort	N = 3971 patients visiting memory clinic in Amsterdam UMC, The Netherlands, from the Amsterdam Aging Cohort, no specific diagnosis.Mean ± SD age (yrs): 67.5 ± 10.844.9% Female9.5% with EOH18.2% with DPOH	Supine 3 minutes, OH after 1 and 3 minutes, divide in early OH (only at 1 minute) and delayed/prolonged OH (at 1 and 3 or only at 3 minutes).	Imaging: CT or 1.5 T MRI, FLAIR and T2 images.Assessor: Two trained specialists and supervised by a clinical radiologist according to the local dementia protocol.Lacunes: Presence of lacunes (≥1)	Adjusted for: age, sex, OH-inducing medication, MMSE score, CVD, diabetes and supine SBP.	No statistically significant association between OH and lacunes.Lacunes ≥1 (OR, 95%CI),EOH: 0.70 (0.47–1.06)DPOH: 1.21 (0.91–1.62)

BMI: body mass index; BP: Blood pressure; CAD: Coronary artery disease; CI: confidence interval; CT: computer tomography; CVD: cardiovascular disease; DBP: diastolic blood pressure; FLAIR: fluid-attenuated inversion recovery; FPG: fasting plasma glucose; HDL: high density lipoprotein; IQR: interquartile range; LDL: low density lipoprotein; MMSE: mini-mental state exam; MRI: magnetic resonance imaging; N: number; NOH: no orthostatic hypotension; OH: orthostatic hypotension; OR: odds ratio; SBP: systolic blood pressure; SD: standard deviation; yrs: years.