摘要
目的 通过大样本横断面调查了解三级甲等医院80岁及以上老年人高血压患者位性低血压患病率及相关危险因素。 方法 采取问卷调查方法进行全国多中心联合调查，对象为28个三级甲等医院门诊和（或）住院的年龄≥80岁的高血压患者，1 298例年龄80～101岁高血压患者纳入研究。测量其卧位和直立位3 min内血压值，并通过问卷调查表对相关资料进行收集分析。其中体位性低血压组316例，非体位性低血压组982例。 结果 本研究人群OH患病率为24.3%（316例）。年龄和性别在体位性低血压组和对照组间差异无统计学意义。体位性低血压组较非体位性低血压组卧位收缩压（P＝0.003）、卧位舒张压（P＝0.000）高；立位舒张压（P＝0.000）、卧位舒张压（P＝0.000）低；冠心病（P＝0.037）、脑卒中（P＝0.001）和肾脏损害（P＝0.014）高。Logistic回归分析结果显示，体位性低血压患病率与卧位收缩压（OR：1.196，CI：1.153～1.242，P＝0.000）、舒张压（OR：1.740，CI：1.602～1.885，P＝0.000）呈正相关，与立位收缩压（OR：0.824，CI：0.795～0.855，P＝0.000）、舒张压（OR：0.584，CI：0.539～0.634，P＝0.000）呈负相关。 结论 三甲医院80岁及以上老年人高血压患者中体位性低血压患病率较高，血压控制不佳可增加体位性低血压的复发情况。
Objective To investigate the prevalence of orthostatic hypotension in hypertensive patients aged 80 or over and associated risk factors at level A tertiary hospitals. Methods A multi- center cross-sectional study was conducted among very old hypertensive patients（≥80 years） at 28 level A tertiary hospitals by using questionnaire-based surveys. A total of 1298 hypertensive subjects aged between 80 and 101 years were enrolled in this study. Blood pressures was measured in the supine position and the upright position within three minutes of standing, and 316 patients were assigned to the orthostatic hypotension（OH） group and the other 982 patients to the non-orthostatic hypotension（NOH） group. Additional information was acquired through patientsp medical records and the questionnaire. Results The prevalence of OH was 24.3 % （316 cases） There were no significan different betueen OH patienl with NOHones in gender and age. OH patients had higher supine systolic and diastolic blood pressure（P= 0. 003 and 0. 000, respectively）, lower standing systolic and diastolic blood pressure（P=0. 000 and 0. 000, respectively）, and higher rates of past coronary heart disease, stroke and renal abnormalities （P = 0. 037, 0. 001 and 0. 014, respectively） than NOH patients. Logistic regression analysis showed that the prevalence of OH in the patients was positively correlated with supine systolic blood pressure（OR ： 1. 196, CI： 1. 153-1. 242, P ： 0. 000） and supine diastolic blood pressure （OR ： 1. 740, CI： 1. 602-1. 885, P = 0. 000） and was negatively correlated with standing systolic blood pressure（OR = 0. 824, CI： 0. 795-0. 855, P = 0. 000） and standing diastolic blood pressure （OR = 0. 584, CI： 0. 539-0. 634, P = 0. 000） . Conclusions The prevalence of orthostatic hypotension is high in hypertensive patients aged 80 years or over at level A tertiary hospitals. Poor blood pressure control may increase the risk of orthostatic hypotension.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2016年第6期662-666,共5页
Chinese Journal of Geriatrics
关键词
老年人
80以上
高血压
低血压
Elderly,aged over 80 years
Hypertension
Hypotension
