体位性低血压变化对死亡率的影响：HOMO研究

Impact of variations in blood pressure with orthostatism on mortality: the HOMO study.

作者信息

Velilla-Zancada Sonsoles M, Escobar-Cervantes Carlos, Manzano-Espinosa Luis, Prieto-Diaz Miguel A, Ramalle-Gomara Enrique, Vara-Gonzalez Luis A

机构信息

aPrimary Care Center Arnedo, Arnedo, La Rioja bCardiology Department, La Paz University Hospital cInternal Medicine, Ramón y Cajal University Hospital, Madrid dPrimary Care Center Vallobín-La Florida, Oviedo, Asturias eDivision of Epidemiology and Disease Prevention, La Rioja Regional Authority,Logroño fPrimary Care Center Castilla-Hermida, Santander, Cantabria, Spain.

出版信息

Blood Press Monit. 2017 Aug;22(4):184-190. doi: 10.1097/MBP.0000000000000251.

DOI:10.1097/MBP.0000000000000251

PMID:28263203

Abstract

OBJECTIVE

The aim of this study was to determine the impact of orthostatic hypotension (OH) and orthostatic hypertension (OHT) on all-cause mortality.

PATIENTS AND METHODS

A total of, 1176 adults from the community over 18 years of age were included in this ambispective study. The mean follow-up was 9.4 years. OH and OHT were defined as a decrease or an increase, respectively, in systolic blood pressure (BP) of at least 20 mmHg and/or diastolic BP of at least 10 mmHg from sitting to standing position at 1 and/or 3 min after standing. The impact of systolic or diastolic OH and systolic or diastolic OHT at 1 and 3 min after standing was also analyzed separately.

RESULTS

In total, 135 individuals died during the follow-up. Neither OH [hazard ratio (HR) 1.23; 95% confidence interval (CI): 0.72-2.10] nor OHT (HR 0.90; 95% CI: 0.59-1.38) was associated with all-cause mortality in the adjusted models. In contrast, systolic OHT at 3 min (HR 2.31; 95% CI: 1.14-4.68) was independently associated with global mortality.

CONCLUSION

Systolic OHT at 3 min is associated with all-cause mortality. The determination of this parameter could add valuable prognostic information during the routine examination of patients.

摘要

目的

本研究旨在确定体位性低血压（OH）和体位性高血压（OHT）对全因死亡率的影响。

患者与方法

本双向性研究纳入了1176名18岁以上的社区成年居民。平均随访时间为9.4年。OH和OHT分别定义为站立后1分钟和/或3分钟时，收缩压（BP）从坐位到站立位至少降低20 mmHg和/或舒张压至少降低10 mmHg，以及收缩压和/或舒张压至少升高上述幅度。同时，还分别分析了站立后1分钟和3分钟时收缩期或舒张期OH以及收缩期或舒张期OHT的影响。

结果

随访期间共有135人死亡。在调整模型中，OH（风险比[HR] 1.23；95%置信区间[CI]：0.72 - 2.10）和OHT（HR 0.90；95% CI：0.59 - 1.38）均与全因死亡率无关。相比之下，站立3分钟时的收缩期OHT（HR 2.31；95% CI：1.14 - 4.68）与总体死亡率独立相关。