Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
Br Med Bull. 2015 Sep;115(1):123-34. doi: 10.1093/bmb/ldv025. Epub 2015 May 20.
Orthostatic hypotension (OH) is very common, particularly in older populations. Diagnostic criteria exist but appear to be arbitrary rather than evidence based. This review will visit the evidence for diagnostic strategies for OH.
Medline (OvidSP), EMBASE (OvidSP), ISI Web of Science, the Health Technology Assessments Database and the Cochrane Library.
A 5-min rest is required before measuring baseline. An active stand with continuous blood pressure (BP) monitoring is preferable to a tilt test to identify initial OH in particular. At least 2 min in the upright position is required. A systolic drop of 20 or a diastolic drop of 10 is supported by the evidence. Reproducibility when testing for OH is poor.
Is the active stand preferable to the tilt test to diagnose classical OH? Although continuous BP monitoring increases diagnostic rates, does it improve clinical outcomes? Should symptoms be used to inform diagnosis?
Establishing the long-term clinical outcomes for transient drops in BP detected on continuous, non-invasive monitoring. Evaluating the different patterns of BP drop to aid diagnosis and direct treatment.
直立性低血压（OH）非常常见，尤其是在老年人群中。存在诊断标准，但似乎是任意的，而不是基于证据的。本综述将探讨 OH 的诊断策略的证据。
Medline（OvidSP）、EMBASE（OvidSP）、ISI Web of Science、卫生技术评估数据库和 Cochrane 图书馆。
测量基线前需要 5 分钟的休息时间。主动站立并连续监测血压优于倾斜试验，特别是在识别初始 OH 方面。至少需要在直立位置 2 分钟。证据支持收缩压下降 20mmHg 或舒张压下降 10mmHg。测试 OH 时的重现性较差。
主动站立是否优于倾斜试验来诊断经典 OH？虽然连续血压监测可提高诊断率，但它是否能改善临床结局？是否应根据症状来协助诊断？
确定在连续非侵入性监测中检测到的短暂血压下降的长期临床结局。评估不同类型的血压下降以协助诊断和指导治疗。
