Shibao Cyndya, Lipsitz Lewis A, Biaggioni Italo
Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
J Am Soc Hypertens. 2013 Jul-Aug;7(4):317-24. doi: 10.1016/j.jash.2013.04.006. Epub 2013 May 27.
This paper provides recommendations on the treatment of orthostatic hypotension (OH) as reviewed by the American Society of Hypertension. It focuses on recent reports on the evaluation and management of OH and provides practical advice for clinicians on how to screen, diagnose, and treat patients using behavioral, nonpharmacologic, and pharmacologic strategies. The authors also provide a stepwise approach on how to apply new findings to successfully control OH and reduce the risk of syncope and falls in these patients. Treatment of OH is also discussed in special situations such as in hypertensive and hospitalized patients. It should be noted, however, that research in this area is mostly limited to studies in small numbers of patients. Unfortunately, the trials of the type needed to develop evidence-based guidelines are not available for this condition.
本文提供了美国高血压学会所综述的关于体位性低血压（OH）治疗的建议。它聚焦于近期有关OH评估与管理的报告，并为临床医生提供了关于如何使用行为、非药物和药物策略来筛查、诊断和治疗患者的实用建议。作者还提供了一种逐步方法，说明如何应用新发现来成功控制OH并降低这些患者晕厥和跌倒的风险。OH的治疗也在特殊情况（如高血压患者和住院患者）中进行了讨论。然而，应当指出的是，该领域的研究大多限于对少数患者的研究。不幸的是，针对这种情况，尚无法开展用以制定循证指南所需类型的试验。
