Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria 3050, Australia.
Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Age Ageing. 2021 Sep 11;50(5):1520-1528. doi: 10.1093/ageing/afab090.
Initial orthostatic hypotension (OH) is a clinical syndrome of exaggerated transient orthostasis associated with higher risks of falls, frailty and syncope in older adults.
To provide a prevalence estimate of initial OH in adults aged 65 years or older.
Literature search of MEDLINE (from 1946), Embase (from 1947) and Cochrane Central Register of Controlled Trials was performed until 6 December 2019, using the terms 'initial orthostatic hypotension', 'postural hypotension' and 'older adults'. Articles were included if published in English and participants were 65 years or older. Random effects models were used for pooled analysis.
Of 5,136 articles screened, 13 articles (10 cross-sectional; 3 longitudinal) reporting data of 5,465 individuals (54.5% female) from the general (n = 4,157), geriatric outpatient (n = 1,136), institutionalised (n = 55) and mixed (n = 117) population were included. Blood pressure was measured continuously and intermittently in 11 and 2 studies, respectively. Pooled prevalence of continuously measured initial OH was 29.0% (95% CI: 22.1-36.9%, I2 = 94.6%); 27.8% in the general population (95% CI: 17.9-40.5%, I2 = 96.1%), 35.2% in geriatric outpatients (95% CI: 24.2-48.1%, I2 = 95.3%), 10.0% in institutionalised individuals (95% CI: 2.4-33.1%, I2 = 0%) and 21.4% in the mixed population (95% CI: 7.0-49.6, I2 = 0%). Pooled prevalence of intermittently measured initial OH was 5.6% (95% CI: 1.5-18.9%, I2 = 81.1%); 1.0% in the general population (95% CI: 0.0-23.9%, I2 = 0%) and 7.7% in geriatric outpatients (95% CI: 1.8-27.0%, I2 = 86.7%).
The prevalence of initial OH is high in older adults, especially in geriatric outpatients. Proper assessment of initial OH requires continuous blood pressure measurements.
初始体位性低血压（OH）是一种与老年人更高跌倒风险、虚弱和晕厥相关的过度短暂直立相关的临床综合征。
提供 65 岁及以上成年人初始 OH 的患病率估计。
对 MEDLINE（1946 年起）、Embase（1947 年起）和 Cochrane 对照试验中心注册库进行文献检索，检索日期截至 2019 年 12 月 6 日，使用的术语有“初始体位性低血压”、“体位性低血压”和“老年人”。如果发表的文章为英文且参与者为 65 岁或以上，则将其纳入。使用随机效应模型进行汇总分析。
在筛选出的 5136 篇文章中，有 13 篇（10 篇横断面；3 篇纵向）文章纳入了来自一般人群（n=4157）、老年门诊（n=1136）、机构化（n=55）和混合人群（n=117）的数据，共涉及 5465 名个体（女性占 54.5%）。11 项研究连续测量血压，2 项研究间歇性测量血压。连续测量初始 OH 的汇总患病率为 29.0%（95%CI：22.1-36.9%，I2=94.6%）；一般人群为 27.8%（95%CI：17.9-40.5%，I2=96.1%），老年门诊为 35.2%（95%CI：24.2-48.1%，I2=95.3%），机构化人群为 10.0%（95%CI：2.4-33.1%，I2=0%），混合人群为 21.4%（95%CI：7.0-49.6%，I2=0%）。间歇性测量初始 OH 的汇总患病率为 5.6%（95%CI：1.5-18.9%，I2=81.1%）；一般人群为 1.0%（95%CI：0.0-23.9%，I2=0%），老年门诊为 7.7%（95%CI：1.8-27.0%，I2=86.7%）。
初始 OH 在老年人中患病率较高，尤其是在老年门诊患者中。正确评估初始 OH 需要连续测量血压。
