老年高血压患者体位性低血压的相关因素分析和干预措施  

Risk factors and intervention measures of orthostatic hypotension in elderly patients with hypertension

作　　者：方根强[1] 胡燕[1] 高艳虹[1] FANG Gen-qiang;HU Yan;GAO Yan-hong(Department of Geriatrics Medicine,Xinhua Hospital,School of Medicine,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院老年医学科,上海200092

出　　处：《岭南心血管病杂志》2020年第2期210-213,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨老年高血压患者体位性低血压(orthostatic hypotension,OH)的相关因素,并提出合理的干预措施以降低OH的发生率。方法选取2016年9月至2018年6月在新华医院老年医学科诊治的老年高血压患者217例,OH组57例,非OH组(NOH组)160例。比较两组的基线资料、降压药物使用情况、基础疾病情况。危险因素的筛选采用Logistics多因素回归分析。结果Logistics多因素回归分析结果显示年龄(OR=1.335,95%CI:1.125~1.584,P=0.002)、α受体阻断药(OR=1.582,95%CI:1.239~2.020,P=0.000)、降压药物≥3种(OR=1.452,95%CI:1.169~1.804,P=0.018)、心房颤动(OR=1.362,95%CI:1.206~1.538,P=0.008)和合并疾病≥2种(OR=1.485,95%CI:1.241~1.777,P=0.001)是OH的独立危险因素。结论老年高血压患者OH的发生率与高龄、α受体阻断药、心房颤动、合并多种疾病以及联合应用≥3种降压药物有关,必须对这些因素加以有针对性的干预,以降低OH发生率。Objectives To analyze the risk factors of orthostatic hypotension(OH)in elderly hypertensive patientsand put forward reasonable intervention measures,in order to reduce the incidence of OH.MethodsTotally 217 elderly hypertensive patients were included in this study from the Department of Geriatrics in Xinhua Hospital duringSeptember 2016 to June 2018,who were divided into OH group(n=57)and non-OH group(n=160).The baseline da-ta,using of antihypertensive drugs and basic diseases were compared between the two groups,and the risk factorswere analyzed by Logistics multiple factors regression analysis.ResultsLogistics multiple factors regression analysisshowed that the independent risk factors for OH were age(OR=1.335,95%CI:1.125-1.584,P=0.002),adrenergicalpha receptor blockers(OR=1.582,95%CI:1.239-2.020,P=0.000),antihypertensive drugs≥3(OR=1.452,95%CI:1.169-1.804,P=0.018),atrial fibrillation(OR=1.362,95%CI:1.206-1.538,P=0.008)and combined diseases≥2(OR=1.485,95%CI:1.241-1.777,P=0.001).ConclusionsThe incidence of OH in elderly hypertensive patientsrelates to age,adrenergic alpha receptor blockers,atrial fibrillation,combined diseases and taking≥2 kinds of antihy-pertensive drugs.We must take measures for these factors,in order to reduce the incidence of OH.

关 键 词：高血压 体位性低血压 老年疾病 危险因素分析 

分 类 号：R544.1[医药卫生—心血管疾病]