老年人直立性低血压危险因素分析

霍楚宁; 李贯绯; 李淞

doi:10.16766/j.cnki.issn.1674-4152.003748

老年人直立性低血压危险因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003748

1.
长春中医药大学临床医学院，吉林长春 130117
2.
吉林省人民医院神经内科，吉林长春 130021

基金项目:

吉林省科技发展计划项目 20200403121SF

详细信息

通讯作者:
李淞，E-mail：lisongz0801@126.com

中图分类号: R544.2
计量
- 文章访问数: 31
- HTML全文浏览量: 11
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2024-02-28
- 网络出版日期: 2024-12-31

Analysis of risk factors for orthostatic hypotension in the elderly

1.
School of Clinical Medicine, Changchun University of Traditional Chinese Medicine, Changchun, Jilin 130117, China

摘要

摘要: 目的探讨老年人直立性低血压(OH)患病率及危险因素，为优化老年OH患者调整血压措施提供科学依据。方法连续纳入2023年1—12月吉林省人民医院神经内科门诊及住院患者，对年龄≥60岁的360例患者进行病史采集及卧位和立位1~3 min内收缩压、舒张压、心率的测量，根据卧立位血压结果，将研究对象分为OH组(47例)和非OH组(313例)。应用SPSS 20.0统计学软件对老年人OH患病情况进行统计分析，采用多因素logistic回归模型分析影响OH患病率的危险因素。结果 (1) 老年人OH患病率为13.1%(47/360)，且患病率随年龄增长而增加(P＜0.001)。(2)OH组与非OH组老年患者年龄(t=11.603，P＜0.001)、卧位收缩压(t=3.427，P=0.001)、立位收缩压(t=3.712，P＜0.001)、立位舒张压(t=3.731，P＜0.001)、高血压病(χ²=32.093，P＜0.001)差异均有统计学意义。(3)多因素logistic回归分析结果显示：年龄、卧位收缩压、立位收缩压、立位舒张压、高血压病为OH的危险因素。结论老年人OH患病率较高，且患病率随年龄增长而增加。合并高血压病者OH的患病率明显高于一般人群，应及早进行针对性干预。
- 直立性低血压 /
- 患病率 /
- 危险因素
Abstract: Objective To explore the prevalence rate and risk factors of orthostatic hypotension (OH) in the elderly, and to provide scientific basis for optimizing blood pressure adjustment measures in elderly OH patients. Methods Medical history collection, systolic and diastolic blood pressure and heart rate measurement within 1-3 minutes of lying and standing position were performed on 360 patients aged ≥60 years from January to December 2023. According to the results of lying and standing blood pressure, the study subjects were divided into OH group (47 cases) and non-OH group (313 cases). SPSS 20.0 statistical software was used for descriptive statistical analysis of the OH prevalence in the elderly, and multiple logistic regression model was used to analyze the risk factors affecting the prevalence of OH. Results (1) The prevalence of OH in the elderly was 13.1% (47/360), and the prevalence increased with age (P < 0.001). (2) Age (t=11.603, P < 0.001), supine systolic blood pressure (t=3.427, P=0.001), orthostatic systolic blood pressure (t=3.712, P < 0.001), orthostatic diastolic blood pressure (t=3.731, P < 0.001), and hypertension (χ²=32.093, P < 0.001) were significant differences between OH group and non-OH group. (3)The results of the multivariate logistic regression analysis indicated that age, supine systolic blood pressure, standing systolic blood pressure, standing diastolic blood pressure, and hypertension are risk factors for orthostatic hypotension. Conclusion The prevalence of OH is higher in the elderly, and the prevalence increases with age. The prevalence rate of OH in patients with hypertension is significantly higher than that of the general population, and targeted intervention should be carried out early.
- Orthostatic hypotension /
- Prevalence /
- Risk factors

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表 1 OH组与非OH组老年患者一般资料比较

Table 1. Comparison of general data of elderly patients between the OH group and the non-OH group

项目	非OH组(n=313)	OH组(n=47)	统计量	P值
性别[例(%)]			0.086^a	0.769
男性	167(53.4)	24(51.1)
女性	146(46.6)	23(48.9)
年龄(x±s，岁)	68.0±5.2	77.9±6.9	11.603^b	＜0.001
BMI(x±s)	23.6±2.5	24.3±3.7	1.650^b	0.100
卧位收缩压(x±s，mmHg)	137.4±19.6	147.8±17.2	3.427^b	0.001
卧位舒张压(x±s，mmHg)	79.3±11.5	82.4±12.6	1.678^b	0.094
卧位心率(x±s，次/min)	74.4±11.0	74.4±11.5	0.024^b	0.981
立位收缩压(x±s，mmHg)	136.7±21.6	124.2±19.8	3.712^b	＜0.001
立位舒张压(x±s，mmHg)	83.9±11.6	76.9±14.1	3.731^b	＜0.001
立位心率(x±s，次/min)	80.7±12.6	80.7±12.6	0.020^b	0.984
总胆固醇[M(P₂₅, P₇₅)，mmol/L]	4.3(3.8, 5.0)	4.0(3.4, 4.8)	-1.723^c	0.085
甘油三酯[M(P₂₅, P₇₅)，mmol/L]	1.5(1.0, 2.3)	1.6(1.1, 2.5)	0.419^c	0.675
高密度脂蛋白(x±s，mmol/L)	1.3±0.4	1.3±0.4	0.589^b	0.556
低密度脂蛋白(x±s，mmol/L)	2.1±0.8	2.1±0.6	0.138^b	0.890
空腹血糖(x±s，mmol/L)	5.3±2.4	5.5±1.7	0.640^b	0.523
糖化血红蛋白(x±s，%)	5.3±1.3	5.6±1.3	1.839^b	0.067
同型半胱氨酸[M(P₂₅, P₇₅)，mmol/L]	12.6(8.6, 16.7)	11.2(7.2, 16.4)	-1.466^c	0.143
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 OH组与非OH组老年患者共患疾病情况比较[例(%)]

Table 2. Comparison of comorbidity between the OH group and the non-OH group [cases (%)]

组别	例数	高血压	血脂异常	糖尿病	冠心病	脑卒中
非OH组	313	128(40.9)	75(24.0)	68(21.7)	20(6.4)	48(15.3)
OH组	47	40(85.1)	12(25.5)	11(23.4)	5(10.6)	8(17.0)
χ²值		32.093	0.055	0.067	1.138	0.088
P值		＜0.001	0.815	0.795	0.286	0.766

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表 3 OH组与非OH组老年患者不良生活行为情况比较[例(%)]

Table 3. Comparison of adverse life behaviors between the OH group and the non-OH group [cases (%)]

组别	例数	吸烟	缺乏运动	饮酒	高盐饮食
非OH组	313	78(24.9)	102(32.6)	19(6.1)	35(11.2)
OH组	47	14(29.8)	12(25.5)	6(12.8)	6(12.8)
χ²值		0.509	0.940	2.827	0.102
P值		0.476	0.332	0.093	0.750

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表 4 老年患者OH影响因素的logistic回归分析

Table 4. Logistic regression analysis of factors influencing OH in elderly patients

变量	B	SE	Waldχ²	P值	OR值(95% CI)
年龄	0.208	0.047	19.462	＜0.001	1.232(1.123~1.351)
卧位收缩压	0.154	0.028	31.408	＜0.001	1.167(1.106~1.232)
立位收缩压	-0.126	0.022	31.929	＜0.001	0.882(0.844~0.921)
立位舒张压	-0.071	0.026	7.656	0.006	0.931(0.885~0.979)
高血压病	2.050	0.691	8.809	0.003	7.765(2.006~30.058)

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