老年高血压患者发生体位性低血压危险因素的探讨

摘要

目的探讨老年高血压患者发生体位性低血压（ OH）的危险因素。方法选择150例年龄≥70岁老年高血压患者，测量卧、立位血压，其中47例OH患者作为观察组，非OH患者103例为对照组。比较两组的年龄、血化验指标（胆固醇、低密度脂蛋白胆固醇、尿素氮、肌酐、脑钠肽）、合并疾病（糖尿病、慢性心功能不全、慢性肾功能不全、高脂血症）、服用≥3种降压药的人数，分析引起OH的危险因素。结果 OH总检出率31．3％，≥90岁患者检出率为84．6％，显示随年龄增加OH检出率增加。年龄、尿素氮、肌酐、脑钠肽在两组分布差异显著（P＜0．01，P＜0．05），Logistic逐步回归分析显示年龄、糖尿病、慢性心功能不全、服用≥3种降压药为OH发病相关危险因素。结论老年高血压患者OH随年龄增加发病率增高，年龄、服用≥3种降压药、糖尿病、慢性心功能不全是OH的危险因素。%Objective To investigate the risk factors of orthostatic hapolension ( OH) in elderly hypertensive patients.Methods Recumbent position and vertical position blood pressure were tested in 150 cases of hospitalized hy-pertensive patients,and the patients were divided into the OH group (n=47) and the non-OH group (n=103).Com-parisons were made between the two groups concerning factors such as age,cholesterol (TC),low density lipoprotein cholesterol (LDL-C),blood urea nitrogen (BUN),creatinine (Cr),brain natriuretic peptide (BNP),numbers of pa-tients with diabetes, chronic cardiac insufficiency, chronic renal insufficiency, hyperlipaemia and taking more than 3 kinds antihypertensive drugs,and the risk factor of OH was analyzed.Results Total incidence of OH was 31.3%.The incidence of patients with≥90 years old was 84.6%,showing that the incidence increased with age.There was signif-icant difference between two groups concerning the age,BUN,Cr,BNP (P<0.01,P<0.05).Age,diabetes,chronic cardiac insufficiency and taking more than 3 kinds antihypertensive drugs were risk factors of OH by Logistic regres-sion analysis.Conclusion The incidence of OH increases with age and the possible risk factors of OH were age,dia-betes,chronic cardiac insufficiency and taking more than 3 kinds of antihypertensive drugs in elderly hypertensive patients.