Velten Ana Paula Costa, Benseñor Isabela, Souza Juliana Bottoni de, Mill José Geraldo
Universidade Federal do Espírito Santo, São Mateus, Brasil.
Universidade de São Paulo, São Paulo, Brasil.
Cad Saude Publica. 2019 Aug 12;35(8):e00123718. doi: 10.1590/0102-311X00123718.
This study aimed to investigate factors associated with orthostatic hypotension in 14,833 individuals 35-74 years of age. This was a cross-sectional study of baseline data (2008-2010) from the Longitudinal Study of Adult Health (ELSA-Brasil). Postural testing was performed after 20 minutes resting in supine position and active adoption of orthostatic posture. Blood pressure was measured in supine position and at 3 minutes in orthostatic position with an oscillometer (HEM 705 CP, Omron, São Paulo, Brazil). Orthostatic hypotension was defined as a drop of ≥ 20mmHg in systolic blood pressure and/or a drop of ≥ 10mmHg in diastolic blood pressure. The target covariates were sex, age bracket, race/color, schooling, nutritional status, waist circumference, alteration in the ankle-brachial index, pulse wave velocity, systolic and diastolic blood pressure, hypertension, diabetes, use of antihypertensives, cholesterol, triglycerides, Chagas disease serology, symptoms, and heart rate variation in the postural test, self-reported heart disease, acute myocardial infarction (AMI)/revascularization, and stroke. Orthostatic hypotension was significantly associated with higher age bracket, OR = 1.83 (95%CI: 1.14-2.95); alteration in the ankle-brachial index, OR = 2.8 (95%CI: 1.13-6.88); AMI/revascularization, OR = 1.70 (95%CI: 1.01-2.87); report of heart disease, OR = 3.03 (95%CI: 1.71-5.36); increased systolic blood pressure, OR = 1.012 (95%CI: 1.006-1.019); positive Chagas disease serology, OR = 2.29 (95%CI: 1.23-4.27); and occurrence of symptoms with postural change, OR = 20.81 (95%CI: 14.81-29.24). Presence of orthostatic hypotension can be a warning sign for cardiovascular disorders and thus a useful tool for screening and prevention.
本研究旨在调查14833名35至74岁个体中与体位性低血压相关的因素。这是一项基于成人健康纵向研究（ELSA - Brasil）基线数据（2008 - 2010年）的横断面研究。在仰卧位休息20分钟后主动采取体位性姿势进行体位测试。使用示波血压计（HEM 705 CP，欧姆龙，巴西圣保罗）在仰卧位和体位性姿势3分钟时测量血压。体位性低血压定义为收缩压下降≥20mmHg和/或舒张压下降≥10mmHg。目标协变量包括性别、年龄组、种族/肤色、受教育程度、营养状况、腰围、踝臂指数改变、脉搏波速度、收缩压和舒张压、高血压、糖尿病、抗高血压药物使用情况、胆固醇、甘油三酯、恰加斯病血清学、症状以及体位测试中的心率变化、自我报告的心脏病、急性心肌梗死（AMI）/血运重建和中风。体位性低血压与较高年龄组显著相关，OR = 1.83（95%CI：1.14 - 2.95）；踝臂指数改变，OR = 2.8（95%CI：1.13 - 6.88）；AMI/血运重建，OR = 1.70（95%CI：1.01 - 2.87）；心脏病报告，OR = 3.03（95%CI：1.71 - 5.36）；收缩压升高，OR = 1.012（95%CI：1.006 - 1.019）；恰加斯病血清学阳性，OR = 2.29（95%CI：1.23 - 4.27）；以及体位改变时出现症状，OR = 20.81（95%CI：14.81 - 29.24）。体位性低血压的存在可能是心血管疾病的一个警示信号，因此是筛查和预防的一个有用工具。
