Wu J S, Wu N H, Lu F H, Chang C J
Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Republic of China, Taiwan.
Am J Hypertens. 1996 Oct;9(10 Pt 1):999-1005. doi: 10.1016/0895-7061(96)00151-3.
Factors associated with orthostatic hypotension are heterogeneous, and some of the factors are interrelated and interdependent, which may confound their relationships to orthostatic hypotension. To investigate the factors that were most likely related to orthostatic hypotension, a study of community-dwelling persons (419 men and 309 women) was conducted. Blood pressures and heart rates were measured after the subjects had been recumbent for 5 min and upright for 1 min. A total of 119 persons (16.3%) experienced orthostatic hypotension. Univariate analysis showed that orthostatic hypotension was associated with the following variables: hypertension, diabetes mellitus, cerebrovascular disease, proteinuria, abnormal renal function, or medications use. Those patients with orthostatic hypotension were older in age and had a higher body mass index, seated blood pressure, plasma creatinine, hemoglobin A1c, fasting and 2-h postload glucose levels than those without orthostatic hypotension. Multivariate analysis revealed that diabetes mellitus, hypertension, and age were independently associated factors for orthostatic hypotension. The higher the level of plasma hemoglobin A1c (%) elevation, the higher the likelihood of orthostatic hypotension manifestation. Clinically, elderly persons or patients with hypertension or diabetes mellitus should receive regular monitoring of supine and upright blood pressure in order to detect orthostatic hypotension and prevent its complications.
与直立性低血压相关的因素多种多样，其中一些因素相互关联且相互依存，这可能会混淆它们与直立性低血压之间的关系。为了研究最有可能与直立性低血压相关的因素，对社区居住者（419名男性和309名女性）进行了一项研究。在受试者卧位5分钟和直立1分钟后测量血压和心率。共有119人（16.3%）出现直立性低血压。单因素分析显示，直立性低血压与以下变量相关：高血压、糖尿病、脑血管疾病、蛋白尿、肾功能异常或药物使用。与无直立性低血压的患者相比，直立性低血压患者年龄更大，体重指数、坐位血压、血浆肌酐、糖化血红蛋白、空腹及餐后2小时血糖水平更高。多因素分析显示，糖尿病、高血压和年龄是直立性低血压的独立相关因素。血浆糖化血红蛋白（%）升高水平越高，直立性低血压表现的可能性越大。临床上，老年人或高血压或糖尿病患者应定期监测仰卧位和直立位血压，以便发现直立性低血压并预防其并发症。
