Fisher Alex A, McLean Allan J, Davis Michael W, Le Couteur David G
Department of Geriatric Medicine, The Canberra Hospital, Woden, Australian Capital Territory, Australia.
National Ageing Research Institute, University of Melbourne, Parkville, Australia.
Curr Ther Res Clin Exp. 2003 Mar;64(3):206-14. doi: 10.1016/S0011-393X(03)00023-7.
Orthostatic hypotension, postprandial hypotension, and falls are considered to be adverse drug reactions of antihypertensive therapy in older people with comorbidities. Concerns regarding these adverse events may limit the use of antihypertensive agents in this group of people.
The aim of this study was to determine the relationship between antihypertensive therapy in octo- and nonagenarians and the risk for orthostatic hypotension, postprandial hypotension, and falls.
This was a case-control study of octo- and nonagenarians living in residential care facilities who were receiving antihypertensive therapy and a control group who were not receiving antihypertensive therapy.
A total of 119 patients, 77 who were receiving regular antihypertensive therapy and 42 who were not taking any antihypertensive agents, were enrolled in the study. The prevalence of antihypertensive use, orthostatic hypotension, postprandial hypotension, and falls was high (65%, 29%, 57%, and 45%, respectively). There were no associations between antihypertensive therapy and orthostatic hypotension, postprandial hypotension, and falls. When individual classes of antihypertensive agents were examined, the only observed association was a negative association (ie, a protective effect) between potassium-sparing diuretics and falls (odds ratio, 0.2; 95% CI, 0.04-1.0).
Antihypertensive therapy was not associated with an increased risk for orthostatic hypotension, postprandial hypotension, or falls in this case-control study of octo- and nonagenarians living in residential care facilities.
体位性低血压、餐后低血压和跌倒被认为是患有合并症的老年人抗高血压治疗的药物不良反应。对这些不良事件的担忧可能会限制该人群中抗高血压药物的使用。
本研究的目的是确定八九十岁老人的抗高血压治疗与体位性低血压、餐后低血压和跌倒风险之间的关系。
这是一项针对居住在养老院且正在接受抗高血压治疗的八九十岁老人以及未接受抗高血压治疗的对照组的病例对照研究。
共有119名患者纳入研究，其中77名正在接受常规抗高血压治疗，42名未服用任何抗高血压药物。抗高血压药物使用、体位性低血压、餐后低血压和跌倒的患病率都很高（分别为65%、29%、57%和45%）。抗高血压治疗与体位性低血压、餐后低血压和跌倒之间没有关联。在检查各类抗高血压药物时，唯一观察到的关联是保钾利尿剂与跌倒之间的负相关（即保护作用）（比值比，0.2；95%置信区间，0.04 - 1.0）。
在这项针对居住在养老院的八九十岁老人的病例对照研究中，抗高血压治疗与体位性低血压、餐后低血压或跌倒风险增加无关。
