Institute for Ageing and Health, Newcastle University, England, UK.
Am J Geriatr Psychiatry. 2009 Nov;17(11):996-9. doi: 10.1097/JGP.0b013e3181b4bf35.
Studies examining vascular risk factors in depression report conflicting evidence but have not assessed orthostatic hypotension, a recently recognized risk factor for white matter hyperintensities.
The authors used noninvasive phasic orthostatic blood pressure monitoring to assess orthostatic hypotension in 17 subjects with late-life major depression and 17 comparison subjects. All received a neuropsychiatric assessment and standardized cardiovascular assessment.
The authors found a higher proportion of subjects met standard criteria for orthostatic hypotension in the depressed group (94% versus 65%, X = 4.5, df = 1, p = 0.034), and the degree of systolic blood pressure drop on standing was highly significantly greater in this group (t = 4.02, df = 32, p <0.001; mean drop of 46 mm Hg). Depressed subjects also experienced more clinical symptoms consistent with orthostatic hypotension.
Our findings suggest orthostatic hypotension may be an important factor in explaining the absence of an excess of clinically determined vascular risk factors in late-life depression.
研究抑郁患者血管风险因素的报告存在相互矛盾的证据，但并未评估体位性低血压，这是一种最近被认识到的与脑白质高信号相关的风险因素。
作者使用非侵入性相位体位血压监测来评估 17 例老年期抑郁症患者和 17 例对照组患者的体位性低血压。所有患者均接受神经精神评估和标准化心血管评估。
作者发现，抑郁组中符合体位性低血压标准的患者比例更高（94%比 65%，X = 4.5，df = 1，p = 0.034），该组的收缩压在站立时下降幅度也显著更大（t = 4.02，df = 32，p <0.001；平均下降 46 毫米汞柱）。抑郁患者还经历了更多与体位性低血压一致的临床症状。
我们的发现表明，体位性低血压可能是解释老年期抑郁症患者临床确定的血管风险因素无增加的一个重要因素。
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