Gutkin Michael, Stewart Julian M
Hypertension Section, Saint Barnabas Medical Center, Livingston, New Jersey, USA;
Center for Hypotension, New York Medical College, Valhalla, New Jersey, USA.
Am J Hypertens. 2016 Sep;29(9):1009-19. doi: 10.1093/ajh/hpw023. Epub 2016 Apr 1.
When patients complain of altered consciousness or discomfort in the upright posture, either relieved by recumbency or culminating in syncope, physicians may find themselves baffled. There is a wide variety of disorders that cause abnormal regulation of blood pressure and pulse rate in the upright posture. The aim of this focused review is 3-fold. First, to offer a classification (nosology) of these disorders; second, to illuminate the mechanisms that underlie them; and third, to assist the physician in the practical aspects of diagnosis of adult orthostatic hypotension, by extending clinical skills with readily available office technology.
当患者诉说意识改变或直立位不适,平卧后缓解或最终导致晕厥时,医生可能会感到困惑。有多种疾病可导致直立位时血压和脉搏率调节异常。本重点综述的目的有三个。第一,对这些疾病进行分类(疾病分类学);第二,阐明其潜在机制;第三,通过利用现成的门诊技术扩展临床技能,协助医生在成人直立性低血压的实际诊断方面提供帮助。