Naschitz Jochanan E, Rosner Itzhak
Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel.
Postgrad Med J. 2007 Sep;83(983):568-74. doi: 10.1136/pgmj.2007.058198.
According to the 1996 consensus definition, orthostatic hypotension (OH) is diagnosed when a fall in systolic blood pressure of at least 20 mm Hg and/or diastolic blood pressure of at least 10 mm Hg within 3 min of standing is recorded. The elements of orthostatic blood pressure drop that are relevant to the definition of OH include magnitude of the drop, time to reach the blood pressure difference defined as OH, and reproducibility of the orthostatic blood pressure drop. In each of these elements, there exist issues that argue for modification of the presently accepted criteria of OH. Additional questions need to be addressed. Should one standard orthostatic test be applied to different patient populations or should tests be tailored to the patients' clinical circumstances? Are different OH thresholds relevant to various clinical settings, aetiologies of OH and comorbidity? Which test has the best predictive power of morbidity and mortality?
根据1996年的共识定义，当记录到站立3分钟内收缩压至少下降20毫米汞柱和/或舒张压至少下降10毫米汞柱时，即可诊断为直立性低血压（OH）。与OH定义相关的直立性血压下降要素包括下降幅度、达到定义为OH的血压差值的时间以及直立性血压下降的可重复性。在这些要素的每一个方面，都存在一些问题，支持对目前公认的OH标准进行修改。还需要解决其他问题。是应该对不同的患者群体应用一种标准的直立性测试，还是应该根据患者的临床情况量身定制测试？不同的OH阈值是否与各种临床环境、OH的病因和合并症相关？哪种测试对发病率和死亡率具有最佳的预测能力？
