[症状性直立性低血压和直立性血压变化的患病率]
[Prevalence of symptomatic orthostatic hypotension and orthostatic blood pressure changes].
作者信息
Shen Dantong, Xie Zhiquan, Pan Chunmei, Zhong Yixin, Lin Zhongqiu, Li Zhiliang
机构信息
Department of Cardiology, Zhujiang Hospital, Second Clinical Medical College of Southern Medical University, Guangzhou 510010, China.
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出版信息
Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Apr;42(4):314-20.
OBJECTIVE
To analyze the prevalence and orthostatic blood pressure changes in subjects with symptomatic orthostatic hypotension (OH), and to observe the relation between symptoms and orthostatic blood pressure change in this population.
METHODS
A total of 193 subjects who consulted physicians due to OH related symptoms were selected, and divided into three groups: young (n = 37), middle-aged (n = 66) and elder (n = 90). Height, body weight, waist circumference, hip circumference and resting heart rate were measured. Symptom scores of every subject were obtained. CAVI and ABI were measured. Blood pressure including recumbent position, orthostatic systolic and diastolic blood pressure was measured at the morning and at the afternoon on two separate examination days with at least one week interval. After that, orthostatic changes in systolic blood pressure (OCs) and orthostatic changes in diastolic blood pressure (OCd) were calculated.
RESULTS
OH prevalence was 32.6% in this cohort. The prevalence of three groups was similar [young: 32.4%, middle-aged: 25.8%, and elderly: 37.8%, respectively (P > 0.05)]. Only 9 cases (14.29% of confirmed OH cases) reached the OH diagnostic criteria with equal or more than 2 times orthostatic blood pressure measurements. OH was diagnosed in 63 patients during the 4 times orthostatic blood pressure check, of which 19.5% to 57.14% cases were diagnosed with single orthostatic blood pressure check. Age, weight, body mass index, waist-to-hip ratio, smoking, drinking habit, sex, coronary heart disease, hypertension, Parkinson's disease, stroke history, antihypertensive drug use were similar between OH group and non-OH group. Height, waist circumference, hip circumference, and resting heart rate were significantly lower in OH group than in non-OH group (P < 0.05). The values of the factors in OH group were lower. CAVI was 8.45 ± 0.19 in non-OH group and 8.37 ± 0.27 in OH group (P > 0.05), ABI was significantly lower in OH group than in non-OH group (1.004 ± 0.013 vs. 1.051 ± 0.009, P < 0.01).
CONCLUSION
The prevalence of OH in people with related symptoms is high. Repeated orthostatic blood pressure measurements can improve OH detection rate.
目的
分析有症状性直立性低血压（OH）受试者的患病率及直立性血压变化情况，并观察该人群中症状与直立性血压变化之间的关系。
方法
选取193例因OH相关症状就诊的受试者，分为三组：青年组（n = 37）、中年组（n = 66）和老年组（n = 90）。测量身高、体重、腰围、臀围和静息心率。获取每位受试者的症状评分。测量颈股动脉脉搏波速度（CAVI）和踝臂指数（ABI）。在至少间隔一周的两个不同检查日的上午和下午测量包括卧位、直立位收缩压和舒张压在内的血压。之后，计算收缩压的直立性变化（OCs）和舒张压的直立性变化（OCd）。
结果
该队列中OH患病率为32.6%。三组患病率相似[青年组：32.4%，中年组：25.8%，老年组：37.8%，分别（P > 0.05）]。仅9例（确诊OH病例的14.29%）通过等于或超过2次直立性血压测量达到OH诊断标准。在4次直立性血压检查期间，63例患者被诊断为OH，其中19.5%至57.14%的病例通过单次直立性血压检查被诊断。OH组和非OH组在年龄、体重、体重指数、腰臀比、吸烟、饮酒习惯、性别、冠心病、高血压、帕金森病、中风病史、使用降压药物方面相似。OH组的身高、腰围、臀围和静息心率显著低于非OH组（P < 0.05）。OH组中各因素的值较低。非OH组CAVI为8.45±0.19，OH组为8.37±0.27（P > 0.05），OH组ABI显著低于非OH组（1.004±0.013对1.051±0.009，P < 0.01）。
结论
有相关症状人群中OH患病率较高。重复直立性血压测量可提高OH检出率。
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