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维生素 D 状况与老年人直立性低血压无关。

Vitamin D Status Is Not Associated With Orthostatic Hypotension in Older Adults.

机构信息

From the Department of Medical Gerontology, The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College, Dublin, Ireland (E.J.L., T.M., A.M.O., D.C., C.O., R.A.K.).

Department of Biochemistry, St James's Hospital, Dublin, Ireland (M.H.).

出版信息

Hypertension. 2019 Sep;74(3):639-644. doi: 10.1161/HYPERTENSIONAHA.119.13064. Epub 2019 Jul 22.

Abstract

There has been much interest in investigating vitamin D status with orthostatic hypotension. However, studies have been small, inconsistent, and with a lack of standardization. The aim of this study was to investigate the association with vitamin D status in a large, nationally representative older adult population using a traceable standard of measurement and an accurate assessment of beat-to-beat blood pressure (BP). This study used participants aged >50 years from The Irish Longitudinal Study on Ageing. Impaired stabilization of BP on standing was defined as a sustained drop of ≥20 mm Hg systolic BP or ≥10 mm Hg diastolic BP up to 40 seconds post stand (impaired stabilization of BP on standing). We also analyzed participants who sustained a drop of ≥20 mm Hg systolic BP or ≥10 mm Hg diastolic BP throughout the 110 seconds stand (OH110). Vitamin D was categorized into sufficient (≥50 nmol/L), insufficient (30-50 nmol/L), and deficient (<30 nmol/L) status. After exclusion criteria 4209 participants were included. Those with deficiency were more likely to be smokers, take antihypertensive medications and had higher levels of cardiovascular disorders compared with those with sufficient status. In a univariate logistic regression those with deficient (odds ratio, 1.18; 95% CI, 0.86-1.61; P=0.303) or insufficient (odds ratio, 1.13; 95% CI, 0.91; P=0.272) status were no more likely to have evidence of impaired stabilization of BP on standing on active stand compared with sufficiency. Similar findings were found for OH110: deficient (odds ratio, 0.85; 95% CI, 0.52-1.40; P=0.528) or insufficient (odds ratio, 0.86; 95% CI, 0.61-1.21; P=0.384) versus sufficiency. In conclusion, vitamin D is not significantly associated with orthostatic hypotension in older adults.

摘要

人们对维生素 D 状态与直立性低血压的关系很感兴趣。然而,这些研究规模较小,结果不一致,且缺乏标准化。本研究的目的是使用可溯源的测量标准和准确评估逐搏血压(BP),在一个大型的、具有全国代表性的老年人群中调查维生素 D 状态与直立性低血压的关系。本研究使用了来自爱尔兰老龄化纵向研究的年龄大于 50 岁的参与者。站立时血压稳定受损定义为站立后 40 秒内收缩压持续下降≥20mmHg 或舒张压下降≥10mmHg(站立时血压稳定受损)。我们还分析了在 110 秒站立期间持续收缩压下降≥20mmHg 或舒张压下降≥10mmHg 的参与者(OH110)。维生素 D 分为充足(≥50nmol/L)、不足(30-50nmol/L)和缺乏(<30nmol/L)状态。排除标准后,共纳入 4209 名参与者。与充足状态相比,缺乏组更可能为吸烟者、服用降压药物且心血管疾病水平更高。在单变量逻辑回归中,与充足状态相比,缺乏(比值比,1.18;95%可信区间,0.86-1.61;P=0.303)或不足(比值比,1.13;95%可信区间,0.91;P=0.272)的参与者在主动站立时,更不可能有站立时血压稳定受损的证据。对于 OH110,也有类似的发现:缺乏(比值比,0.85;95%可信区间,0.52-1.40;P=0.528)或不足(比值比,0.86;95%可信区间,0.61-1.21;P=0.384)与充足状态相比,没有显著差异。总之,维生素 D 与老年人直立性低血压无显著相关性。

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