老年高血压患者体位性血压改变及其对神经认知障碍的影响

摘要

Objective To explore the characteristics of blood pressure change in posture among old - aged hypertensive patients and the association of orthostatic hypotension ( OH ) with major neurocognitive disorder. Methods Seventy seven hypertensive patients were included in this study and received orthostatic blood pressure measurement. OH was defined as a decrease of at least 20mmHg SBP or a decrease of DBP at least 10 mmHg while orthostatic hypertension ( OHT ) as an elevation of SBP by 20mmHg or more, others except these two conditions were classified into orthostatic normotension ( ONT ). Results The prevalence rates of OH and OHT were 18.2% and 9.0% respectively in hypertensive patients. There is no significant difference in age among these three groups. The major neurocognitive disorder was more frequently seen in hypertensive patients with OH. Conclusion OH may be an important factor for aggravation of neurocognitive disorder.%目的 探索高龄干部人群中高血压患者体位造成血压变化的特点以及体位性血压改变与明显的神经认知障碍的关系.方法 对入选77例高血压患者进行卧立位血压测量,体位性低血压(OH)定义为直立位后收缩压下降≥2.6 kPa (20 mmHg) 或舒张压下降≥1.3 kPa (10 mmHg),将直立位后收缩压升高≥2.6 kPa (20 mmHg) 定义为体位性高血压(OHT),无上述两种异常者定义为体位性血压正常(ONT).结果 在住院高血压患者中,OH发生率18.2%,OHT发生率为9.0%,3组在年龄方面无统计学差异,OH组明显的神经认知障碍发生率显著高于ONT组.结论 高龄高血压患者中,OH可能是加重神经认知障碍的重要因素之一.