First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, Athens, Greece.
Department of Cardiology, Helena Venizelou Hospital, Athens, Greece.
J Clin Hypertens (Greenwich). 2019 Mar;21(3):426-433. doi: 10.1111/jch.13491. Epub 2019 Feb 6.
Orthostatic hypertension (OHT), that is, sustained increase in blood pressure after standing, is an increasingly recognized cardiovascular disorder having been examined in much fewer studies compared with orthostatic hypotension (OH). However, in both OHT and OH, dysfunction of the autonomous nervous system is considered to be the primary pathophysiological disturbance, while significant associations with essential hypertension have been observed. Although in many studies OHT has been related to subclinical or clinical target organ damage, there is also evidence denying such an association. Because OHT is defined variably across different studies, the comparison of relevant outcomes is at least problematic. Since evidence about OHT treatment is exclusively based on limited non-randomized studies, no specific recommendations have been developed. Therefore, both the prognostic role and the clinical significance of OHT remain largely undefined. The aim of the present review is to summarize the available evidence regarding the definition, diagnosis, pathophysiology, prognostic role and treatment of OHT and highlight potential clinical implications of this underestimated condition.
直立性高血压（OHT），即站立后血压持续升高，与直立性低血压（OH）相比，它是一种越来越受到关注的心血管疾病，但在 OHT 和 OH 中，自主神经系统功能障碍被认为是主要的病理生理紊乱，同时与原发性高血压有显著关联。尽管在许多研究中 OHT 与亚临床或临床靶器官损害有关，但也有证据否认这种关联。由于 OHT 在不同研究中的定义各不相同，因此相关结果的比较至少存在问题。由于关于 OHT 治疗的证据仅基于有限的非随机研究，因此尚未制定具体建议。因此，OHT 的预后作用和临床意义在很大程度上仍未得到明确。本综述的目的是总结有关 OHT 的定义、诊断、病理生理学、预后作用和治疗的现有证据，并强调这种被低估的情况的潜在临床意义。
