Orthostatic hypotension predicts mortality in elderly men - The Honolulu Heart Program
Orthostatic hypotension predicts mortality in elderly men - The Honolulu Heart Program
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DOI：
10.1161/01.cir.98.21.2290
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发表时间：
1998-11-24
期刊：
影响因子：
37.8
通讯作者：
Curb, JD
中科院分区：
文献类型：
--
作者：
Masaki, KH;Schatz, IJ;Curb, JD
背景——关于体位性低血压对流动老年患者（尤其是少数群体）死亡率的预测价值，目前尚无基于人群的数据。方法和结果——利用檀香山心脏计划第四次检查（1991年至1993年）的数据，对3522名71岁至93岁的日裔美国男性队列中随后的LE年全因死亡率进行了评估，评估了体位性低血压与随后的LE年全因死亡率的关系。使用标准化方法测量仰卧位和站立 3 分钟后的血压。直立性低血压定义为收缩压（SBP）下降大于或等于20毫米汞柱，或舒张压下降大于或等于10毫米汞柱。体位性低血压的总体患病率为 6.9%，并且随着年龄的增长而增加。 4 年间，该队列中共有 473 人死亡；死亡者中，52 人患有直立性低血压。患有和不患有体位性低血压的患者的四年年龄调整死亡率分别为每 1000 人年 56.6 例和 38.6 例。使用Cox比例风险模型，在调整年龄、吸烟、糖尿病、体重指数、体力活动、坐位收缩压、抗高血压药物、血细胞比容、酒精摄入量以及中风、冠心病和癌症的患病率后，体位性低血压是4年全因死亡率的一个显着的独立预测因子（相对风险1.64，95% CI 1.19至2.26）。从仰卧位到站立位的收缩压变化与 4 年死亡率之间存在显着的线性相关性（线性趋势检验，P
Background-Population-based data are unavailable concerning the predictive value of orthostatic hypotension on mortality in ambulatory elderly patients, particularly minority groups.Methods and Results-With the use of data from the Honolulu Heart Program's fourth examination (1991 to 1993), orthostatic hypotension was assessed in relation to subsequent LE-year all-cause mortality among a cohort of 3522 Japanese American men 71 to 93 years old. Blood pressure was measured in the supine position and after 3 minutes of standing, with the use of standardized methods. Orthostatic hypotension was defined as a drop in systolic blood pressure (SBP) of greater than or equal to 20 mm Hg or in diastolic blood pressure of greater than or equal to 10 mm Hg. Overall prevalence of orthostatic hypotension was 6.9% and increased with age. There was a total of 473 deaths in the cohort over 4 years; of those who died, 52 had orthostatic hypotension. Four-year age-adjusted mortality rates in those with and without orthostatic hypotension were 56.6 and 38.6 per 1000 person-years, respectively. With the use of Cox proportional hazards models, after adjustment for age, smoking, diabetes mellitus, body mass index, physical activity, seated systolic blood pressure, antihypertensive medications, hematocrit, alcohol intake, and prevalent stroke, coronary heart disease and cancer, orthostatic hypotension was a significant independent predictor of 4-year all-cause mortality (relative risk 1.64, 95% CI 1.19 to 2.26). There was a significant linear association between change in systolic blood pressure from supine position to standing and 4-year mortality rates (test for linear trend, P