老年人高血压患者合并体位性低血压的发生率及危险因素探讨  

Exploration of Prevalence and Risk Factors for Orthostatic Hypotension in Elderly Hypertension Patients

作　　者：徐加加[1] 林仲秋[1] 董凤英[1] 冯国飞[1] 段跃兴[1] 孙宁宁[1] 全馨雪 谢志泉[1] XU Jia-jia LIN Zhong-qiu DONG Feng-ying FENG Guo-fei DUAN Yue-xing SUN Ning-ning QUAN Xin-xue XIE Zhi-quan.(The Forth Cadres Ward, General Hospital of Guangzhou Military Command, Guangzhou （510010）, Guangdong, China)

机构地区：[1]广州军区广州总医院干部病房四科,广东省广州市510010

出　　处：《中国循环杂志》2017年第10期989-993,共5页Chinese Circulation Journal

基　　金：广州市健康医疗协同创新重大专项(158100062);广东省科技计划项目(2016ZC0208)

摘　　要：目的:探讨老年人高血压患者合并体位性低血压(orthostatic hypotension,OH)的发生率及相关危险因素。方法:对长期居住广州的军队离退休老年人进行健康普查,选取65岁以上的高血压患者532例,分为单纯高血压(高血压组,n=414),高血压合并OH(H+OH组,n=118),比较两组患者的年龄(65~79岁、≥80岁)、血压等级(高血压1~3级)、合并疾病等情况,应用多因素Logistic逐步回归分析高血压合并OH的相关危险因素。结果:高血压合并OH的发生率为22.2%(118例/532例)。H+OH组中65~79岁、≥80岁者所占比例分别为6.7%、23.1%,两者比较差异有统计学意义(P<0.05);高血压1级、高血压2级和高血压3级患者OH的发生率分别为12.6%、23.3%和25.2%,三者间比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示卧位收缩压、立位即刻血压、卧位心率、立位2 min心率、慢性心功能不全为高血压合并OH发病影响因素(P<0.05)。结论:老年高血压患者随年龄增加OH发病率增高,高血压合并OH与年龄、高血压病情严重程度、慢性心功能不全等因素相关。Objective： To explore the prevalence and risk factors of orthostatic hypotension （OH） in elderly hypertension patients. Methods： A total of 532 retired hypertension patients elder than 65 years in Guangzhou military region were enrolled. The patients were divided into 2 groups： Hypertension group, n=414 and Hypertension combining OH （H＋OH） group, n=118. The patient＆#39;s age （65-79、≥ 80）, hypertension grade （Grade 1-3） and complication status were studied. The risk factors for H＋OH prevalence were analyzed by multivariate Logistic regression analysis. Results： The incidence rate of H＋OH was 22.2% （118/532）. In H＋OH group, the ratios of elderly and very elderly patients were 6.7% and 23.1%, P〈0.05 and the ratios of OH occurrence for hypertension grade 1, 2 and 3 were 12.6%, 23.3% and 25.2% respectively, P〈0.05. Multivariate Logistic regression analysis presented that systolic blood pressure （BP） in supine position, BP at immediate standing, heart rate in supine position, heart rate after 2 minutes standing and chronic cardiac insufficiency were the impact factors for H＋OH occurrence, P〈0.05. Conclusion： In elderly hypertension patients, incidence of OH was increasing with age elevating; H＋OH has been related to age, severity of hypertension and chronic cardiac insufficiency.

关 键 词：高血压 低血压 直立性 老年人 发病率 

分 类 号：R541.4[医药卫生—心血管疾病]