Prof Didier Schoevaerdts, CHU UCL Namur, site Godinne ; Avenue Dr. Gaston Thérasse, 1 ; B-5530 Yvoir, Belgium, Office: +32/81423435, E-mail:
J Nutr Health Aging. 2019;23(10):1026-1033. doi: 10.1007/s12603-019-1271-1.
To explore the prevalence and potential risk factors of postprandial hypotension (PPH) among elderly patients in an acute geriatric ward.
A prospective observational study.
Geriatric Unit in a Belgian tertiary-care University Hospital.
Seventy-six hospitalized elderly patients after stabilization of their acute conditions.
PPH and orthostatic hypotension (OH) measured by a non-invasive automated blood pressure device, demographic data, Katz's Basic Activities of Daily Living (ADL) and Lawton's instrumental ADL, Short Physical Performance Battery, Charlson Comorbidity Index, Mini Nutritional Assessment-Short Form, Timed Up and Go test, Get-up Early test, grip strength and 7 classes of drugs.
Overall, the prevalence of PPH was 46% (n=35/76), and it was symptomatic in 31% of the patients (n=11/35). PPH is associated with OH in one-third of the cases (n=12/35). Two-thirds of the patients with HPP had a significant drop in systolic blood pressure within the first 75 minutes after a meal. In univariate analyses, risk factors of PPH were nursing home residence, alpha-blocker consumption, help needed for eating and a good level of global functional status. However, patients with a good functional status were at increased risk of alpha-blocker exposure. In multivariate analyses, only alpha-blocker consumption and help needed for eating remained statistically significant.
PPH is frequent among hospitalized elderly people in a Geriatric Evaluation and Management Unit, affecting nearly one out of two people. The use of alpha-blockers is an important risk factor and may alert clinicians to the risk of PPH.
探讨老年患者在急性老年病房中餐后低血压(PPH)的患病率和潜在危险因素。
前瞻性观察研究。
比利时三级保健大学医院老年病房。
76 名急性病情稳定后住院的老年患者。
使用非侵入性自动血压装置测量 PPH 和直立性低血压(OH)、人口统计学数据、Katz 的基本日常生活活动(ADL)和 Lawton 的工具性 ADL、简短体能表现电池、Charlson 合并症指数、迷你营养评估-简短形式、起立和行走测试、早起测试、握力和 7 类药物。
总体而言,PPH 的患病率为 46%(n=35/76),其中 31%(n=11/35)的患者出现症状。PPH 与 OH 相关的占三分之一(n=12/35)。三分之二的 HPP 患者在餐后 75 分钟内收缩压显著下降。单因素分析中,PPH 的危险因素包括居住在养老院、使用α-受体阻滞剂、进食需要帮助和整体功能状态良好。然而,功能状态良好的患者因使用α-受体阻滞剂而增加了风险。多因素分析中,只有使用α-受体阻滞剂和进食需要帮助仍然具有统计学意义。
在老年评估和管理病房中,住院老年人群中 PPH 很常见,近二分之一的人受到影响。使用α-受体阻滞剂是一个重要的危险因素,可能会提醒临床医生注意 PPH 的风险。