Department of Rehabilitation Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Department of Medicine and Aged Care, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.
BMC Geriatr. 2018 Jan 15;18(1):10. doi: 10.1186/s12877-017-0702-2.
Orthostatic hypotension (OH), a blood pressure drop after postural change, is associated with impaired standing balance and falls in older adults. This study aimed to assess the association between blood pressure (BP) and a measure of quality of standing balance, i.e. Center of Pressure (CoP) movement, after postural change from supine to standing position in geriatric outpatients, and to compare CoP movement between patients with and without OH.
In a random subgroup of 75 consecutive patients who were referred to a geriatric outpatient clinic, intermittent BP measurements were obtained simultaneously with CoP measurements in mediolateral and anterior-posterior direction directly after postural change during 3 min of quiet stance with eyes open on a force plate. Additional measurements of continuous BP were available in n = 38 patients. Associations between BP change during postural change and CoP movement were analyzed using Spearman correlation. Mann-Whitney-U tests were used to compare CoP movement between patients with OH and without OH, in which OH was defined as a BP drop exceeding 20 mmHg of systolic BP (SBP) and/or 10 mmHg of diastolic BP (DBP) within 3 min after postural change.
OH measured intermittently was found in 8 out of 75 (11%) and OH measured continuously in 22 out of 38 patients (57.9%). BP change did not associate with CoP movement. CoP movement did not differ significantly between patients with and without OH.
Results do not underpin the added value of CoP movement measurements in diagnosing OH in a clinical setting. Neither could we identify the role of CoP measurements in the understanding of the relation between OH and impaired standing balance.
直立性低血压（OH）是体位改变后血压下降，与老年人站立平衡受损和跌倒有关。本研究旨在评估体位从仰卧位变为站立位后，血压（BP）与站立平衡质量的一种测量指标（即压力中心（CoP）运动）之间的关系，并比较 OH 患者与非 OH 患者之间的 CoP 运动。
在连续就诊的 75 例老年门诊患者中，随机抽取 75 例患者，在安静站立 3 分钟期间，从仰卧位变为站立位后，同时进行间歇性血压测量和 CoP 测量，在力板上睁眼。在 n = 38 例患者中，还可获得连续血压的额外测量。使用 Spearman 相关分析来分析体位变化期间 BP 变化与 CoP 运动之间的关系。使用 Mann-Whitney-U 检验比较 OH 患者和非 OH 患者之间的 CoP 运动，其中 OH 定义为体位变化后 3 分钟内 SBP 下降超过 20mmHg 和/或 DBP 下降超过 10mmHg。
间歇性测量发现 8 例（11%）患者存在 OH，连续测量发现 22 例（57.9%）患者存在 OH。BP 变化与 CoP 运动之间无相关性。OH 患者与非 OH 患者的 CoP 运动无显著差异。
结果不支持 CoP 运动测量在临床诊断 OH 方面的附加价值。我们也无法确定 CoP 测量在理解 OH 与站立平衡受损之间关系中的作用。
