Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
Department of Geriatrics, Westfriesgasthuis, Hoorn, the Netherlands.
J Geriatr Phys Ther. 2019 Jul/Sep;42(3):E28-E34. doi: 10.1519/JPT.0000000000000186.
Orthostatic hypotension (OH), a blood pressure drop after postural change, is a highly prevalent and disabling syndrome in older adults. Yet, the association between physical performance and OH is not clearly established. The aim of this study was to determine whether different types of physical performance are associated with OH in a clinically relevant population of geriatric outpatients.
This cross-sectional study included 280 geriatric outpatients (mean age: 82.2 years, standard deviation: 7.1). Orthostatic hypotension was determined using intermittently measured blood pressure and continuously measured blood pressure in a random subgroup of 58 patients. Physical performance was classified into a dynamic type (4-m Walk Test, Chair Stand Test, and Timed Up and Go test) and a static type (standing balance tests, handgrip strength). Associations were analyzed using logistic regression models with adjustments for age, sex, weight, and height.
Diminished physical performance on the Chair Stand Test was associated with OH measured intermittently. Diminished physical performance on all dynamic physical domains (4-m Walk Test, Chair Stand Test, and Timed Up and Go test) was associated with OH measured continuously. Static physical performance was not significantly associated with OH.
Dynamic physical performance tests with a substantial postural change and center of mass displacement were significantly associated with OH. The influence of physical performance on OH in daily routine activities should be further explored to establish counteracting interventions.
直立性低血压（OH）是一种体位改变后血压下降的综合征，在老年人中非常普遍且具有致残性。然而，身体表现与 OH 之间的关联尚不清楚。本研究的目的是确定在有临床意义的老年门诊患者人群中，不同类型的身体表现是否与 OH 相关。
本横断面研究纳入了 280 名老年门诊患者（平均年龄：82.2 岁，标准差：7.1）。在 58 名随机亚组患者中使用间歇性测量血压和连续测量血压来确定 OH。身体表现分为动态类型（4 米步行测试、椅子站立测试和计时起立行走测试）和静态类型（站立平衡测试、握力测试）。使用逻辑回归模型进行分析，并调整了年龄、性别、体重和身高。
椅子站立测试中身体表现下降与间歇性测量的 OH 相关。所有动态身体领域（4 米步行测试、椅子站立测试和计时起立行走测试）的身体表现下降与连续测量的 OH 相关。静态身体表现与 OH 无显著相关性。
具有较大体位变化和质心位移的动态身体表现测试与 OH 显著相关。应进一步探讨身体表现对日常生活中 OH 的影响，以确定对抗干预措施。
