老年人直立性低血压的临床表现。
Clinical presentation of orthostatic hypotension in the elderly.
作者信息
Craig G M
机构信息
Northampton Health Authority, UK.
出版信息
Postgrad Med J. 1994 Sep;70(827):638-42. doi: 10.1136/pgmj.70.827.638.
Abstract
Fifty cases of orthostatic hypotension in the elderly are analysed. Three main modes of presentation were identified: (1) falls or mobility problems; (2) mental confusion or dementia; or (3) predominantly cardiac symptoms. Selected case histories are given to illustrate diagnostic difficulties. Medication was responsible for orthostatic hypotension in 66% of patients and striking examples of polypharmacy were encountered. However, 34% of cases were not iatrogenic. Only 14% of patients had overtly postural symptoms. A high index of suspicion is needed to diagnose orthostatic hypotension in the elderly and the condition is often overlooked. The paper provides useful diagnostic clues for clinicians.
摘要
对50例老年体位性低血压患者进行了分析。确定了三种主要表现形式：(1)跌倒或行动问题；(2)精神错乱或痴呆；或(3)以心脏症状为主。给出了选定的病例史以说明诊断困难。66%的患者体位性低血压是由药物引起的，且发现了多药合用的显著例子。然而，34%的病例并非医源性。只有14%的患者有明显的体位症状。诊断老年患者的体位性低血压需要高度的怀疑指数，而且这种情况常常被忽视。本文为临床医生提供了有用的诊断线索。
相似文献
1
Clinical presentation of orthostatic hypotension in the elderly.老年人直立性低血压的临床表现。
Postgrad Med J. 1994 Sep;70(827):638-42. doi: 10.1136/pgmj.70.827.638.
2
Etiology of Syncope and Unexplained Falls in Elderly Adults with Dementia: Syncope and Dementia (SYD) Study.老年痴呆症患者晕厥及不明原因跌倒的病因：晕厥与痴呆（SYD）研究
J Am Geriatr Soc. 2016 Aug;64(8):1567-73. doi: 10.1111/jgs.14225. Epub 2016 Jun 28.
3
Medication Use and Fall-Related Hospital Admissions from Long-Term Care Facilities: A Hospital-Based Case-Control Study.长期护理机构的药物使用与跌倒相关的住院情况：一项基于医院的病例对照研究。
Drugs Aging. 2017 Aug;34(8):625-633. doi: 10.1007/s40266-017-0472-8.
4
[Iatrogenic orthostatic hypotension in the elderly].[老年人医源性直立性低血压]
Clin Ter. 1986 Nov 15;119(3):209-14.
5
Comorbidity in heart failure in the elderly.
Clin Geriatr Med. 2000 Aug;16(3):631-48. doi: 10.1016/s0749-0690(05)70032-x.
6
Orthostatic hypotension in organic dementia: relationship between blood pressure, cortical blood flow and symptoms.器质性痴呆中的体位性低血压：血压、皮质血流量与症状之间的关系。
Clin Auton Res. 1996 Feb;6(1):29-36. doi: 10.1007/BF02291403.
7
Depressive Symptoms and Orthostatic Hypotension Are Risk Factors for Unexplained Falls in Community-Living Older People.抑郁症状和直立性低血压是社区居住的老年人不明原因跌倒的危险因素。
J Am Geriatr Soc. 2016 May;64(5):1073-8. doi: 10.1111/jgs.14104.
8
Orthostatic hypotension: an often overlooked risk factor for falls.直立性低血压：一种常被忽视的跌倒风险因素。
Geriatr Nurs. 2018 Jul-Aug;39(4):483-486. doi: 10.1016/j.gerinurse.2018.06.009. Epub 2018 Jul 13.
9
[Orthostatic hypotension in the elderly].[老年人直立性低血压]
Praxis (Bern 1994). 1996 Feb 6;85(6):145-9.
10
Orthostatic hypotension and low blood pressure in organic dementia: a study of prevalence and related clinical characteristics.器质性痴呆中的体位性低血压和低血压：患病率及相关临床特征研究
Int J Geriatr Psychiatry. 1997 Mar;12(3):395-403.
引用本文的文献
1
Disentangling the phenotypic patterns of hypertension and chronic hypotension.解析高血压和慢性低血压的表型模式。
J Biomed Inform. 2024 Nov;159:104743. doi: 10.1016/j.jbi.2024.104743. Epub 2024 Oct 31.
2
Long-term antipsychotic use, orthostatic hypotension and falls in older adults with Alzheimer's disease.长期使用抗精神病药物与老年阿尔茨海默病患者直立性低血压和跌倒的关系。
Eur Geriatr Med. 2024 Apr;15(2):527-537. doi: 10.1007/s41999-023-00910-x. Epub 2024 Jan 2.
3
Management Strategies for Comorbid Supine Hypertension in Patients with Neurogenic Orthostatic Hypotension.神经源性直立性低血压伴仰卧位高血压的合并症管理策略。
Curr Neurol Neurosci Rep. 2021 Mar 9;21(4):18. doi: 10.1007/s11910-021-01104-3.
4
Orthostatic hypotension and health-related quality of life among community-living older people in Korea.韩国社区居住老年人的直立性低血压与健康相关生活质量。
Qual Life Res. 2020 Jan;29(1):303-312. doi: 10.1007/s11136-019-02295-6. Epub 2019 Sep 12.
5
Neurogenic Orthostatic Hypotension in Parkinson Disease: A Primer.帕金森病中的神经源性直立性低血压：入门指南。
Neurol Ther. 2019 Dec;8(2):307-324. doi: 10.1007/s40120-019-00152-9. Epub 2019 Aug 27.
6
Characterization of the symptoms of neurogenic orthostatic hypotension and their impact from a survey of patients and caregivers.通过对患者和护理人员的调查来描述神经源性直立性低血压的症状及其影响。
BMC Neurol. 2018 Aug 25;18(1):125. doi: 10.1186/s12883-018-1129-x.
7
Clinical Relevance of Orthostatic Hypotension in Neurodegenerative Disease.体位性低血压在神经退行性疾病中的临床相关性
Curr Neurol Neurosci Rep. 2015 Dec;15(12):78. doi: 10.1007/s11910-015-0599-0.
8
Risk factors for falls in older Korean adults: the 2011 Community Health Survey.韩国老年人跌倒的风险因素：2011年社区健康调查
J Korean Med Sci. 2014 Nov;29(11):1482-7. doi: 10.3346/jkms.2014.29.11.1482. Epub 2014 Nov 4.
9
The relationship between orthostatic hypotension and falling in older adults.老年人直立性低血压与跌倒的关系。
Clin Auton Res. 2014 Feb;24(1):3-13. doi: 10.1007/s10286-013-0219-5. Epub 2013 Nov 20.
10
Insights into the clinical management of the syndrome of supine hypertension--orthostatic hypotension (SH-OH): the Irish Longitudinal Study on Ageing (TILDA).仰卧位高血压-直立性低血压（SH-OH）综合征临床管理的新视角：爱尔兰老龄化纵向研究（TILDA）。
BMC Geriatr. 2013 Jul 15;13:73. doi: 10.1186/1471-2318-13-73.
本文引用的文献
1
A neurological syndrome associated with orthostatic hypotension: a clinical-pathologic study.一种与直立性低血压相关的神经综合征：一项临床病理研究。
Arch Neurol. 1960 May;2:511-27. doi: 10.1001/archneur.1960.03840110025004.
2
The hypotensive effect of imipramine hydrocloride in patients with cardiovascular disease.盐酸丙咪嗪对心血管疾病患者的降压作用。
Clin Pharmacol Ther. 1961 May-Jun;2:300-7. doi: 10.1002/cpt196123300.
3
A model of risk of falling for psychogeriatric patients.老年精神科患者跌倒风险模型。
Arch Gen Psychiatry. 1981 Apr;38(4):463-7. doi: 10.1001/archpsyc.1981.01780290097010.
4
Orthostatic hypotension.直立性低血压
Mayo Clin Proc. 1981 Feb;56(2):117-25.
5
Orthostatic hypotension in Parkinson's disease.帕金森病中的体位性低血压
Lancet. 1972 Jan 22;1(7743):174-6. doi: 10.1016/s0140-6736(72)90571-5.
6
Postural disturbances in a 75-year-old population: I. Prevalence and functional consequences.75岁人群的姿势障碍：I. 患病率及功能影响
Age Ageing. 1987 Nov;16(6):393-8. doi: 10.1093/ageing/16.6.393.
7
Causes of ataxia in patients attending a falls laboratory.在一家跌倒实验室就诊的患者共济失调的病因。
Age Ageing. 1988 Mar;17(2):94-102. doi: 10.1093/ageing/17.2.94.
8
Falls by elderly people at home: prevalence and associated factors.老年人在家中跌倒：患病率及相关因素。
Age Ageing. 1988 Nov;17(6):365-72. doi: 10.1093/ageing/17.6.365.
9
Treating postural hypotension.治疗体位性低血压。
Br Med J (Clin Res Ed). 1987 Feb 14;294(6569):390-1. doi: 10.1136/bmj.294.6569.390.
10
The prevalence and aetiology of long-term L-dopa side-effects in elderly parkinsonian patients.老年帕金森病患者长期左旋多巴副作用的患病率及病因
Age Ageing. 1989 Jan;18(1):11-6. doi: 10.1093/ageing/18.1.11.
Zotero 插件