JAMA Intern Med:评估体位性低血压,应以直立1分钟内血压为准

2017-08-07 佚名 中国循环杂志

JAMA内科学子刊研究称,在站立1分钟内测得的血压下降,更能反映患者未来发生头晕、晕厥和跌倒等事件的风险。

JAMA内科学子刊研究称,在站立1分钟内测得的血压下降,更能反映患者未来发生头晕、晕厥和跌倒等事件的风险。

在确定有无与体位有关的血压下降时,人先在平卧位2分钟内测量2-5次血压。之后站起来,以25秒为间隔,测量4至5次血压,出现血压下降(收缩压≥20 mmHg或舒张压≥10 mmHg)即为体位性低血压。

在为期23年的随访过程中,研究人员了记录了接受检查者发生跌倒、骨折、晕厥、车祸和全因死亡率。

结果发现,只有站起后第一次(平均时间为站起后28秒)测定的血压下降者发生头晕的风险增加了49%。

在校正混淆因素后,第一次测定值还与随访期内跌倒、骨折、晕厥、死亡风险最相关。第二次测定值(平均时间为站起后53秒)也与所有长期不良事件都相关。

但1分钟以后,测定的血压下降与长期不良事件的关系就不是全部相关了。

研究者认为,应使用站立1分钟内的血压下降作为针诊断体位性低血压的标准。

同期述评指出,临床医生应测定1分钟和3分钟的血压,因为有些患者要到体位改变后3分钟才出现血压下降。

根据之前的美国神经病学会共识,体位性低血压定义为从仰卧位转为站立位后3分钟,出现血压明显下降(收缩压≥20 mmHg或舒张压≥10 mmHg)。

该研究为社区动脉粥样硬化风险研究的一个亚组研究,共1.1万余人参加。
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    2017-11-10 jyzxjiangqin

    体位性低血压的评估.

    0

  2. 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    2017-10-28 jyzxjiangqin

    评估体位性低血压.

    0

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    2017-10-19 jyzxjiangqin

    体位性低血压.

    0

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GetPortalCommentsPageByObjectIdResponse(id=239624, encodeId=e363239624cd, content=评估体位性低血压., beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Sep 02 08:02:14 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233998, encodeId=1518233998d9, content=评估体位性低血压。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Aug 16 07:43:44 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231751, encodeId=b9a6231e518e, content=评估体位性低血压。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Aug 09 09:58:50 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607924, encodeId=7b10160e924cb, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Aug 09 00:45:00 CST 2017, time=2017-08-09, status=1, ipAttribution=)]
    2017-10-09 jyzxjiangqin

    评估体位性低血压.

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=260190, encodeId=f41e2601909b, content=体位性低血压的评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Nov 10 07:24:19 CST 2017, time=2017-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256618, encodeId=23db25661889, content=评估体位性低血压., beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Oct 28 08:40:50 CST 2017, time=2017-10-28, status=1, ipAttribution=), 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GetPortalCommentsPageByObjectIdResponse(id=239624, encodeId=e363239624cd, content=评估体位性低血压., beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Sep 02 08:02:14 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233998, encodeId=1518233998d9, content=评估体位性低血压。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Aug 16 07:43:44 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=231751, encodeId=b9a6231e518e, content=评估体位性低血压。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Aug 09 09:58:50 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607924, encodeId=7b10160e924cb, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Aug 09 00:45:00 CST 2017, time=2017-08-09, status=1, ipAttribution=)]
    2017-09-25 jyzxjiangqin

    体位性低血压.

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=260190, encodeId=f41e2601909b, content=体位性低血压的评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Nov 10 07:24:19 CST 2017, time=2017-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256618, encodeId=23db25661889, content=评估体位性低血压., beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Oct 28 08:40:50 CST 2017, time=2017-10-28, status=1, ipAttribution=), 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GetPortalCommentsPageByObjectIdResponse(id=239624, encodeId=e363239624cd, content=评估体位性低血压., beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Sep 02 08:02:14 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233998, encodeId=1518233998d9, content=评估体位性低血压。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Aug 16 07:43:44 CST 2017, time=2017-08-16, status=1, ipAttribution=), 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09 00:45:00 CST 2017, time=2017-08-09, status=1, ipAttribution=)]
    2017-09-12 jyzxjiangqin

    评估体位性低血压.

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=260190, encodeId=f41e2601909b, content=体位性低血压的评估., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Nov 10 07:24:19 CST 2017, time=2017-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256618, encodeId=23db25661889, content=评估体位性低血压., beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Oct 28 08:40:50 CST 2017, time=2017-10-28, status=1, ipAttribution=), 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GetPortalCommentsPageByObjectIdResponse(id=239624, encodeId=e363239624cd, content=评估体位性低血压., beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Sep 02 08:02:14 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233998, encodeId=1518233998d9, content=评估体位性低血压。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Aug 16 07:43:44 CST 2017, time=2017-08-16, status=1, ipAttribution=), 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09 00:45:00 CST 2017, time=2017-08-09, status=1, ipAttribution=)]
    2017-09-02 jyzxjiangqin

    评估体位性低血压.

    0

  8. 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GetPortalCommentsPageByObjectIdResponse(id=231751, encodeId=b9a6231e518e, content=评估体位性低血压。, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Aug 09 09:58:50 CST 2017, time=2017-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607924, encodeId=7b10160e924cb, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Aug 09 00:45:00 CST 2017, time=2017-08-09, status=1, ipAttribution=)]
    2017-08-16 jyzxjiangqin

    评估体位性低血压。

    0

  9. 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09 00:45:00 CST 2017, time=2017-08-09, status=1, ipAttribution=)]
    2017-08-09 jyzxjiangqin

    评估体位性低血压。

    0

  10. 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