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餐后低血压:老年人中一个未被充分报道的隐匿杀手。

Postprandial Hypotension: An Underreported Silent Killer in the Aged.

作者信息

Awosika Ayoola, Adabanya Uzochukwu, Millis Richard M, Omole Adekunle E, Moon Jin Hyung

机构信息

College of Medicine, University of Illinois, Chicago, USA.

College of Health Sciences and Professions, Ohio University, Athens, USA.

出版信息

Cureus. 2023 Feb 24;15(2):e35411. doi: 10.7759/cureus.35411. eCollection 2023 Feb.

Abstract

Orthostatic hypotension (OH) is one of the most common autonomic dysfunctions, with high prevalence in populations of elderly, hypertensive, diabetic, or Parkinson's patients. Evidence is emerging that OH co-occurs with postprandial hypotension (PPH); a greater prevalence of PPH than of OH is reported for Parkinson's disease patients. OH is diagnosed by measuring the blood pressure changes associated with postural changes and often produces alterations in consciousness or other such bothersome symptoms as fainting. PPH is diagnosed by measuring the blood pressure changes associated with ingesting high carbohydrate test meals. Because of the time lag between food ingestion and absorption, PPH is often not reported as symptomatic and, therefore, not diagnosed as PPH. OH and PPH are independent predictors for all causes of mortality. Relative underdiagnosis may qualify PPH as a "silent killer" disease. This review is aimed at providing updates on the epidemiology, pathophysiology, and clinical aspects associated with the diagnosis and treatment of PPH. Highlighting the current gaps in knowledge and research about PPH is expected to make medical practitioners more cognizant of the dangers of underdiagnosis and motivate future research to identify individuals and populations at high risk for PPH and its sequelae.

摘要

直立性低血压(OH)是最常见的自主神经功能障碍之一,在老年人、高血压患者、糖尿病患者或帕金森病患者群体中患病率很高。越来越多的证据表明,OH与餐后低血压(PPH)同时出现;据报道,帕金森病患者中PPH的患病率高于OH。OH通过测量与体位变化相关的血压变化来诊断,常导致意识改变或其他令人烦恼的症状,如昏厥。PPH通过测量与摄入高碳水化合物测试餐相关的血压变化来诊断。由于食物摄入和吸收之间存在时间间隔,PPH往往未被报告有症状,因此未被诊断为PPH。OH和PPH是所有死因的独立预测因素。相对诊断不足可能使PPH成为一种“沉默杀手”疾病。本综述旨在提供有关PPH诊断和治疗的流行病学、病理生理学及临床方面的最新信息。强调目前关于PPH的知识和研究空白,有望使医生更加认识到诊断不足的危险性,并推动未来的研究,以识别PPH及其后遗症的高危个体和人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e736/9964048/6ba114be985c/cureus-0015-00000035411-i01.jpg

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