Applegate W B, Davis B R, Black H R, Smith W M, Miller S T, Burlando A J
University of Tennessee, Memphis.
J Am Geriatr Soc. 1991 Nov;39(11):1057-64. doi: 10.1111/j.1532-5415.1991.tb02869.x.
The objective of this study was to examine the prevalence and correlates of postural hypotension (defined as a drop in systolic blood pressure of greater than or equal to 20 mm Hg) in a cohort of elderly persons with isolated systolic hypertension (ISH).
Baseline cross-sectional analysis of the 4,736 persons randomized in the Systolic Hypertension in the Elderly Program (SHEP).
A randomized multi-center double-blind outpatient clinical trial of the impact of treating ISH.
Men and women age greater than or equal to 60 years with the systolic blood pressure (SBP) greater than or equal to 160 mm Hg and diastolic blood pressure (DBP) less than 90 mm Hg.
Medical histories were obtained using interviewer-administered, standardized clinical history forms. At entry into the study, seated and standing BP was measured by certified BP technicians using a random zero sphygmomanometer. Postural hypotension (PH) was assessed at 1 and 3 minutes after the participant arose from a seated position.
PH was found in 10.4% of participants at 1 minute and in 12.0% of participants at 3 minutes. 5.3% of participants demonstrated PH at both time intervals while 17.3% demonstrated PH at either or both of the time intervals. Factors significantly (P less than 0.05) associated with the presence of PH were higher mean SBP and a lower mean body mass index.
Somewhat different persons were defined as having PH based upon the 1 minute and 3 minute standing measures of BP, and prevalence estimates of PH can vary depending on whether one or more intervals of measurement are used. Cross-sectional data analysis indicated that PH, in healthy community-dwelling older persons with ISH, may not be associated with a history of disorders or problems usually thought to be related to PH. However, prospective data are needed to determine the prognostic significance of PH, and whether one or multiple measurements carry more significance.
本研究的目的是调查一组单纯收缩期高血压（ISH）老年人群中体位性低血压（定义为收缩压下降大于或等于20 mmHg）的患病率及其相关因素。
对老年收缩期高血压计划（SHEP）中随机分组的4736人进行基线横断面分析。
一项关于治疗ISH影响的随机多中心双盲门诊临床试验。
年龄大于或等于60岁，收缩压（SBP）大于或等于160 mmHg且舒张压（DBP）小于90 mmHg的男性和女性。
使用由访员管理的标准化临床病史表格获取病史。在研究开始时，由经过认证的血压技术人员使用随机零点血压计测量坐位和站立位血压。在参与者从坐位起身1分钟和3分钟后评估体位性低血压（PH）。
1分钟时10.4%的参与者出现PH，3分钟时12.0%的参与者出现PH。5.3%的参与者在两个时间间隔均出现PH，而17.3%的参与者在其中一个或两个时间间隔出现PH。与PH存在显著相关（P<0.05）的因素是较高的平均SBP和较低的平均体重指数。
根据1分钟和3分钟站立位血压测量，被定义为患有PH的人群略有不同，PH的患病率估计可能因使用一个或多个测量间隔而异。横断面数据分析表明，在患有ISH的健康社区居住老年人中，PH可能与通常认为与PH相关的疾病或问题史无关。然而，需要前瞻性数据来确定PH的预后意义，以及单次或多次测量是否更具意义。
