Movement Disorders Unit and Neuroautonomic service, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Neuroepidemiology. 2014;43(3-4):239-43. doi: 10.1159/000368699. Epub 2014 Dec 16.
Orthostatic hypotension (OH) is a common underdiagnosed condition characterized by a fall in systolic or diastolic blood pressure (BP). There is some uncertainty about the minimum duration needed to detect OH beyond 3 min (delayed OH). We aimed to define a minimum time range for measurement of delayed OH in subjects referred to as tilt testing.
A repeated measurements study Tel-Aviv Medical Center, on 692 subjects who underwent prolonged (40 min, vertical position) drug-free tilt testing. Survival curves were used to study time to an OH event; logistic regression to study factors associated with delayed OH and mixed models to study the pattern of repeated BP measures.
In our sample, 17% had OH within 3 min, 35% within 30 min, and 40% within 40 min. Among the 270 OH patients, 43 and 91% were identified within 3 and 30 min, respectively. Delayed OH was associated with female gender (OR = 1.95, 1.16-3.27) and age <65 years (OR = 2.17, 1.24-3.80). Older patients differed significantly from younger patients in BP pattern changes and had a higher rate of a fall in systolic BP.
Tilt testing for 30 min identifies most cases of delayed OH in older patients, while those younger than 65 years need 10 min longer.
直立性低血压（OH）是一种常见的未被充分诊断的病症，其特征是收缩压或舒张压（BP）下降。对于 OH 检测，超过 3 分钟（延迟 OH）所需的最短持续时间存在一些不确定性。我们旨在确定在进行倾斜测试时，用于检测延迟 OH 的最短时间范围。
在特拉维夫医疗中心对 692 名接受过长时间（40 分钟，垂直位置）无药物倾斜测试的受试者进行了重复测量研究。使用生存曲线研究 OH 事件的时间；逻辑回归研究与延迟 OH 相关的因素；混合模型研究重复 BP 测量的模式。
在我们的样本中，17%的人在 3 分钟内出现 OH，35%的人在 30 分钟内出现 OH，40%的人在 40 分钟内出现 OH。在 270 名 OH 患者中，分别有 43%和 91%在 3 分钟和 30 分钟内被识别。延迟 OH 与女性性别（OR=1.95，1.16-3.27）和年龄<65 岁（OR=2.17，1.24-3.80）相关。与年轻患者相比，老年患者的 BP 模式变化明显不同，且收缩压下降的发生率更高。
倾斜测试 30 分钟可识别大多数老年患者的延迟 OH，而 65 岁以下的患者需要再延长 10 分钟。
