Kwok C S, Ong A C L, Potter J F, Metcalf A K, Myint P K
Cardiovascular Institute, University of Manchester, Manchester, UK; NRP Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norfolk, UK; AGEING (Aberdeen Gerontological & Epidemiological INterdisciplinary Research Group), Epidemiology Group, School of Medicine & Dentistry, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Int J Clin Pract. 2014 Jun;68(6):705-13. doi: 10.1111/ijcp.12373. Epub 2014 Jan 22.
We sought to identify the determinants of orthostatic hypotension (OH) among patients referred to the transient ischaemic attack (TIA) clinic.
We conducted a retrospective analysis of prospectively collected data on patients who attended the TIA clinic in a UK hospital between January 2006 and September 2009. Each patient had their supine and standing or sitting blood pressure measured. Logistic regression was used to estimate the univariate and multivariate odds of OH for the subgroups of patients based on their diagnosis. A 10% significance level for the univariate analysis was used to identify variables in the multivariate model.
A total of 3222 patients were studied of whom 1131 had a TIA, 665 a stroke and 1426 had other diagnoses. The prevalence of either systolic or diastolic OH in the TIA, stroke and patients with other diagnoses was similar being 22% (n = 251), 24% (n = 162) and 20% (n = 292), respectively. Multivariate analyses showed age, prior history of TIA, and diabetes were independently significantly associated with systolic OH alone or diastolic OH alone or either systolic or diastolic OH [ORs 1.03 (1.02-1.05); 1.56 (1.05-2.31); 1.65 (1.10-2.47), respectively]. Among the patients with the diagnosis of stroke, peripheral vascular disease (PVD) was significantly associated with increased odds of OH (3.56, 1.53-8.31), whereas male gender had a significantly lower odds of OH (0.61, 0.42-0.88). In patients with other diagnoses, age (1.04, 1.02-1.05) and diabetes (1.47, 1.04-2.09) were associated with OH, whereas male gender was (0.76, 0.58-1.00) not associated with OH.
Orthostatic hypotension is prevalent among patients presenting to TIA clinic. Previous history of vascular disease (prior TIA/stroke/PVD) appears to be a significant associate of OH in this patient population.
我们试图确定转诊至短暂性脑缺血发作（TIA）门诊的患者中体位性低血压（OH）的决定因素。
我们对2006年1月至2009年9月期间在英国一家医院TIA门诊就诊患者的前瞻性收集数据进行了回顾性分析。测量了每位患者的仰卧位和站立位或坐位血压。采用逻辑回归来估计基于诊断的患者亚组中OH的单变量和多变量比值比。单变量分析采用10%的显著性水平来确定多变量模型中的变量。
共研究了3222例患者，其中1131例患有TIA，665例患有中风，1426例有其他诊断。TIA、中风和其他诊断患者中收缩期或舒张期OH的患病率相似，分别为22%（n = 251）、24%（n = 162）和20%（n = 292）。多变量分析显示，年龄、既往TIA病史和糖尿病分别单独与收缩期OH、舒张期OH或收缩期和舒张期OH显著独立相关[比值比分别为1.03（1.02 - 1.05）；1.56（1.05 - 2.31）；1.65（1.10 - 2.47）]。在中风诊断患者中，外周血管疾病（PVD）与OH的比值比增加显著相关（3.56，1.53 - 8.31），而男性OH的比值比显著较低（0.61，0.42 - 0.88）。在其他诊断患者中，年龄（1.04，1.02 - 1.05）和糖尿病（1.47，1.04 - 2.09）与OH相关，而男性（0.76，0.58 - 1.00）与OH无关。
体位性低血压在就诊于TIA门诊的患者中很常见。血管疾病既往史（既往TIA/中风/PVD）似乎是该患者群体中OH的一个重要相关因素。
