Jones Pearl K, Shaw Brett H, Raj Satish R
a 1 Department of Neurology, University of Texas Health Sciences Center, San Antonio, TX, USA.
b 2 Department of Cardiac Science, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada.
Expert Rev Cardiovasc Ther. 2015 Nov;13(11):1263-76. doi: 10.1586/14779072.2015.1095090. Epub 2015 Oct 1.
Orthostatic hypotension (OH) leads to a significant number of hospitalizations each year, and is associated with significant morbidity and mortality among affected individuals. Given the increased risk for cardiovascular events and falls, it is important to identify the underlying etiology of OH and to choose appropriate therapeutic agents. OH can be non-neurogenic or neurogenic (arising from a central or peripheral lesion). The initial evaluation includes orthostatic vital signs, complete history and a physical examination. Patients should also be evaluated for concomitant symptoms of post-prandial hypotension and supine hypertension. Non-pharmacologic interventions are the first step for treatment of OH. The appropriate selection of medications can also help with symptomatic relief. This review highlights the pathophysiology, clinical features, diagnostic work-up and treatment of patients with neurogenic OH.
直立性低血压（OH）每年导致大量住院治疗，并且在受影响个体中与显著的发病率和死亡率相关。鉴于心血管事件和跌倒风险增加，识别OH的潜在病因并选择合适的治疗药物很重要。OH可分为非神经源性或神经源性（由中枢或外周病变引起）。初始评估包括直立位生命体征、完整病史和体格检查。还应评估患者是否伴有餐后低血压和卧位高血压的症状。非药物干预是OH治疗的第一步。药物的适当选择也有助于缓解症状。本综述重点介绍神经源性OH患者的病理生理学、临床特征、诊断检查和治疗。
