预防和治疗体位性低血压：就像 A、B、C 那么简单。
Preventing and treating orthostatic hypotension: As easy as A, B, C.
机构信息
Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
出版信息
Cleve Clin J Med. 2010 May;77(5):298-306. doi: 10.3949/ccjm.77a.09118.
Abstract
Orthostatic hypotension is a chronic, debilitating illness that is difficult to treat. The therapeutic goal is to improve postural symptoms, standing time, and function rather than to achieve upright normotension, which can lead to supine hypertension. Drug therapy alone is never adequate. Because orthostatic stress varies with circumstances during the day, a patient-oriented approach that emphasizes education and nonpharmacologic strategies is critical. We provide easy-to-remember management recommendations, using a combination of drug and nondrug treatments that have proven efficacious.
摘要
直立性低血压是一种慢性、使人虚弱的疾病，难以治疗。治疗目标是改善姿势症状、站立时间和功能，而不是达到直立血压正常，因为这可能导致仰卧高血压。单独的药物治疗永远不够。由于直立应激在白天的情况下会发生变化，因此强调教育和非药物策略的以患者为中心的方法至关重要。我们提供易于记忆的管理建议，使用已证明有效的药物和非药物治疗组合。
相似文献
1
Preventing and treating orthostatic hypotension: As easy as A, B, C.预防和治疗体位性低血压：就像 A、B、C 那么简单。
Cleve Clin J Med. 2010 May;77(5):298-306. doi: 10.3949/ccjm.77a.09118.
2
[Orthostatic hypotension : diagnosis and therapy].[直立性低血压：诊断与治疗]
Herzschrittmacherther Elektrophysiol. 2011 Jun;22(2):99-106. doi: 10.1007/s00399-011-0132-3.
3
Management of chronic orthostatic hypotension.
Am J Med. 1986 Mar;80(3):454-64. doi: 10.1016/0002-9343(86)90720-5.
4
Cardiovascular Safety Considerations in the Treatment of Neurogenic Orthostatic Hypotension.治疗神经源性直立性低血压的心血管安全性考虑。
Am J Cardiol. 2020 May 15;125(10):1582-1593. doi: 10.1016/j.amjcard.2020.01.037. Epub 2020 Feb 8.
5
Orthostatic hypotension in older people: considerations, diagnosis and management.老年人的直立性低血压：考量、诊断与管理
Clin Med (Lond). 2021 May;21(3):e275-e282. doi: 10.7861/clinmed.2020-1044.
6
Management of postural hypotension.体位性低血压的管理。
Curr Hypertens Rep. 2000 Oct;2(5):457-62. doi: 10.1007/s11906-000-0028-9.
7
Increased impedance to inspiration ameliorates hemodynamic changes associated with movement to upright posture in orthostatic hypotension: a randomized blinded pilot study.增加吸气阻抗可改善体位性低血压患者从卧位转为直立位时的血流动力学变化：一项随机双盲试验研究
Heart Rhythm. 2007 Feb;4(2):128-35. doi: 10.1016/j.hrthm.2006.10.011. Epub 2006 Oct 19.
8
Nonpharmacologic Management of Orthostatic Hypotension in Older People: A Systematic Review. The SENATOR ONTOP Series.老年人直立性低血压的非药物治疗：系统评价。SENATOR ONTOP 系列。
J Am Med Dir Assoc. 2019 Sep;20(9):1065-1073.e3. doi: 10.1016/j.jamda.2019.03.032. Epub 2019 May 17.
9
Management of orthostatic hypotension.直立性低血压的管理。
Am J Hosp Pharm. 1994 Mar 1;51(5):648-60; quiz 697-8.
10
Evaluation and management of orthostatic hypotension.直立性低血压的评估与管理。
Am Fam Physician. 2011 Sep 1;84(5):527-36.
引用本文的文献
1
Standing under pressure: hemodynamic effects of abdominal compression type and intensity in healthy adults.承受压力：腹部按压类型和强度对健康成年人的血流动力学影响
Front Physiol. 2025 Aug 20;16:1621617. doi: 10.3389/fphys.2025.1621617. eCollection 2025.
2
Pyridostigmine in the management of orthostatic hypotension: a systematic review and meta-analysis.吡啶斯的明治疗体位性低血压：一项系统评价与荟萃分析
Open Heart. 2025 Mar 25;12(1):e003106. doi: 10.1136/openhrt-2024-003106.
3
Evidence for targeting autonomic dysfunction in systemic sclerosis: A scoping review.系统性硬化症中针对自主神经功能障碍的证据：一项范围综述。
J Scleroderma Relat Disord. 2025 Jan 8:23971983241308050. doi: 10.1177/23971983241308050.
4
12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2025.12. 视网膜病变、神经病变与足部护理：2025年糖尿病护理标准
Diabetes Care. 2025 Jan 1;48(Supplement_1):S252-S265. doi: 10.2337/dc25-S012.
5
Associations of Hypertension and Orthostatic Hypotension With Subclinical Cardiovascular Disease.高血压和直立性低血压与亚临床心血管疾病的关联。
J Gerontol A Biol Sci Med Sci. 2024 Nov 1;79(11). doi: 10.1093/gerona/glae234.
6
Validation of the Chinese orthostatic discriminant and Severity Scale (ODSS) for detection of orthostatic intolerance syndrome.用于检测直立不耐受综合征的中国直立判别与严重程度量表（ODSS）的验证
Heliyon. 2024 Jul 18;10(15):e34724. doi: 10.1016/j.heliyon.2024.e34724. eCollection 2024 Aug 15.
7
Orthostatic Hypotension in Adults With Hypertension: A Scientific Statement From the American Heart Association.成人高血压患者的直立性低血压：美国心脏协会的科学声明。
Hypertension. 2024 Mar;81(3):e16-e30. doi: 10.1161/HYP.0000000000000236. Epub 2024 Jan 11.
8
12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2024.12. 视网膜病变、神经病变和足部护理：2024 年糖尿病护理标准。
Diabetes Care. 2024 Jan 1;47(Suppl 1):S231-S243. doi: 10.2337/dc24-S012.
9
Midodrine - why don't you just work better?米多君——你怎么就不能更好地发挥作用呢？
Crit Care Resusc. 2023 Oct 16;24(4):296-297. doi: 10.51893/2022.4.E. eCollection 2022 Dec 5.
10
Orthostatic Hypotension, Hypertension Treatment, and Cardiovascular Disease: An Individual Participant Meta-Analysis.直立性低血压、高血压治疗与心血管疾病：一项个体参与者荟萃分析。
JAMA. 2023 Oct 17;330(15):1459-1471. doi: 10.1001/jama.2023.18497.
本文引用的文献
1
Orthostatic hypotension: evaluation and treatment.直立性低血压：评估与治疗
Cardiovasc Hematol Disord Drug Targets. 2007 Mar;7(1):63-70. doi: 10.2174/187152907780059029.
2
Delayed orthostatic hypotension: a frequent cause of orthostatic intolerance.延迟性直立性低血压：直立不耐受的常见原因。
Neurology. 2006 Jul 11;67(1):28-32. doi: 10.1212/01.wnl.0000223828.28215.0b.
3
Pyridostigmine treatment trial in neurogenic orthostatic hypotension.神经源性直立性低血压的吡啶斯的明治疗试验
Arch Neurol. 2006 Apr;63(4):513-8. doi: 10.1001/archneur.63.4.noc50340. Epub 2006 Feb 13.
4
Fludrocortisone in patients with familial dysautonomia--assessing effect on clinical parameters and gene expression.氟氢可的松用于家族性自主神经功能异常患者——评估对临床参数和基因表达的影响
Clin Auton Res. 2005 Aug;15(4):284-91. doi: 10.1007/s10286-005-0288-1.
5
What is the minimum duration of head-up tilt necessary to detect orthostatic hypotension?检测直立性低血压所需的头高位倾斜最短持续时间是多久？
Clin Auton Res. 2005 Apr;15(2):71-5. doi: 10.1007/s10286-005-0246-y.
6
High prevalence of orthostatic hypotension and its correlation with potentially causative medications among elderly veterans.老年退伍军人中体位性低血压的高患病率及其与潜在致病药物的相关性。
J Clin Pharm Ther. 2005 Apr;30(2):173-8. doi: 10.1111/j.1365-2710.2005.00629.x.
7
Use of lower abdominal compression to combat orthostatic hypotension in patients with autonomic dysfunction.使用下腹部压迫法治疗自主神经功能障碍患者的体位性低血压。
Clin Auton Res. 2004 Jun;14(3):167-75. doi: 10.1007/s10286-004-0187-x.
8
Volume and distribution of blood and their significance in regulating the circulation.血液的容量、分布及其在调节循环中的意义。
Physiol Rev. 1953 Apr;33(2):202-28. doi: 10.1152/physrev.1953.33.2.202.
9
The regulation of the blood distribution in man.人体血液分布的调节。
Acta Physiol Scand. 1952;26(4):312-27. doi: 10.1111/j.1748-1716.1952.tb00912.x.
10
Acetylcholinesterase inhibition: a novel approach in the treatment of neurogenic orthostatic hypotension.乙酰胆碱酯酶抑制：治疗神经源性直立性低血压的新方法。
J Neurol Neurosurg Psychiatry. 2003 Sep;74(9):1294-8. doi: 10.1136/jnnp.74.9.1294.
Zotero 插件