German Aerospace Center-DLR, Institute of Aerospace Medicine, Cologne, Germany.
University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Kerpener Str. 62, 50937, Cologne, Germany.
Hypertens Res. 2024 Aug;47(8):2211-2216. doi: 10.1038/s41440-024-01710-x. Epub 2024 May 23.
Orthostatic hypertension, defined by an increase of systolic blood pressure (SBP) of ≥20 mmHg upon standing, harbors an increased cardiovascular risk. We pooled data from two rigorously conducted head-down tilt bedrest studies to test the hypothesis that cardiopulmonary deconditioning and hypovolemia predispose to orthostatic hypertension. With bedrest, peak VO decreased by 6 ± 4 mlO/min/kg (p < 0.0001) and plasma volume by 367 ± 348 ml (p < 0.0001). Supine SBP increased from 127 ± 9 mmHg before to 133 ± 10 mmHg after bedrest (p < 0.0001). In participants with stable hemodynamics following head-up tilt, the incidence of orthostatic hypertension was 2 out of 67 participants before bedrest and 2 out of 57 after bedrest. We conclude that in most healthy persons, cardiovascular deconditioning and volume loss associated with long-term bedrest are not sufficient to cause orthostatic hypertension.
直立性高血压定义为站立时收缩压（SBP）升高≥20mmHg，与心血管风险增加相关。我们对两项严格进行的头低位卧床休息研究的数据进行了汇总，以检验心肺功能不全和血容量不足易导致直立性高血压的假设。卧床休息使峰值 VO 降低了 6±4mlO/min/kg（p<0.0001），血浆容量减少了 367±348ml（p<0.0001）。仰卧位 SBP 从卧床前的 127±9mmHg 增加到卧床后的 133±10mmHg（p<0.0001）。在头高位倾斜后血流动力学稳定的参与者中，卧床前有 2 例（67 例中的 2 例）和卧床后有 2 例（57 例中的 2 例）发生直立性高血压。我们的结论是，在大多数健康人中，与长期卧床相关的心血管功能不全和血容量减少不足以导致直立性高血压。
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