Cooke John, Carew Sheila, Quinn Colin, O'Connor Margaret, Curtin John, O'Connor Caroline, Saunders Jean, Humphreys Eileen, Deburca Stiofan, Clinch David, Lyons Declan
Division of Ageing and Therapeutics, Department of Medicine, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Age Ageing. 2013 Nov;42(6):709-14. doi: 10.1093/ageing/aft112. Epub 2013 Aug 9.
beat-to-beat technology is increasingly used for investigating orthostatic intolerance (OI) but the prevalence of orthostatic hypotension (OH) diagnosed with this technology is unclear.
(i) to use beat-to-beat technology to define the prevalence of OH, (ii) to investigate the pathological correlates of OH, (iii) to report the diversity of postural BP responses.
cross-sectional study of adults ≥ 65 years. BP responses to a 3-min head-up tilt were analysed.
of 326 participants, 203(62.3%) were females. The median (IQR) age was 73 (70-78). One hundred and ninety-one (58.6%) met standard (20 mmHg systolic/10 mmHg diastolic) criteria for OH. The prevalence was higher in females (60.1% F versus 56.1% M); 47% were arteriolar subtype, 33% were venular, 9% were mixed and 11.0% could not be classified. Morphological analysis identified 102 subjects with 'small drop, overshoot', 131 with 'medium drop, slow recovery' and 31 with 'large drop, nonrecovery'. Those with OH had a lower BMI (P = 0.02), a higher resting heart rate (P = 0.005), were more likely to take a psychotropic (P = 0.02), have vertigo (P = 0.004) and report OI (P = 0.02). The 95th centile for the duration of systolic BP (SYSBP) decay >20 mmHg was 175 s and the slope of systolic BP decay was 4.75 mmHg/s. The 5th centile for percentage recovery of SYSBP was 81.4%.
(i) beat-to-beat methods identify a higher prevalence of OH than sphygmomanometry, (ii) the pathological correlates of OH diagnosed in this manner are similar to those described for sphygmomanometry, (iii) there is a diverse pattern of orthostatic BP decay that could be used in future research to predict adverse outcomes in OH.
逐搏技术越来越多地用于研究体位性不耐受（OI），但用该技术诊断的体位性低血压（OH）的患病率尚不清楚。
（i）使用逐搏技术确定OH的患病率，（ii）研究OH的病理相关性，（iii）报告体位性血压反应的多样性。
对≥65岁的成年人进行横断面研究。分析了对3分钟头高位倾斜试验的血压反应。
326名参与者中，203名（62.3%）为女性。年龄中位数（四分位间距）为73岁（70 - 78岁）。191名（58.6%）符合OH的标准（收缩压下降20 mmHg/舒张压下降10 mmHg）。女性患病率更高（女性60.1%对男性56.1%）；47%为小动脉亚型，33%为静脉型，9%为混合型，11.0%无法分类。形态学分析确定102名受试者为“小下降、过冲”型，131名受试者为“中等下降、缓慢恢复”型，31名受试者为“大下降、无恢复”型。患有OH的受试者体重指数较低（P = 0.02），静息心率较高（P = 0.005），更有可能服用精神药物（P = 0.02），有眩晕症状（P = 0.004）并报告有OI（P = 0.02）。收缩压（SYSBP）下降>20 mmHg持续时间的第95百分位数为175秒，收缩压下降斜率为4.75 mmHg/秒。SYSBP恢复百分比的第5百分位数为81.4%。
（i）逐搏方法确定的OH患病率高于血压计测量法，（ii）以这种方式诊断的OH的病理相关性与血压计测量法所描述的相似，（iii）体位性血压下降存在多种模式，可用于未来研究以预测OH的不良结局。
