Small Degree of Lumbar Lordosis as an Overlooked Determinant for Orthostatic Increases in Blood Pressure in the Elderly: The Nagahama Study
Small Degree of Lumbar Lordosis as an Overlooked Determinant for Orthostatic Increases in Blood Pressure in the Elderly: The Nagahama Study
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小程度的腰椎前凸是老年人体位性血压升高的一个被忽视的决定因素：Nagahama 研究
DOI：
10.1093/ajh/hpy137
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发表时间：
2018
影响因子：
3.2
通讯作者：
Nagahama Study Group
中科院分区：
文献类型：
--
作者：
Tabara Yasuharu;Masaki Mitsuhiro;Ikezoe Tome;Setoh Kazuya;Kato Takehiro;Kawaguchi Takahisa;Kosugi Shinji;Nakayama Takeo;Ichihashi Noriaki;Tsuboyama Tadao;Matsuda Fumihiko;Nagahama Study Group
研究背景体位性高血压与心血管预后不良有关，尽管引起体位性血压升高的因素尚不确定。我们调查了弯腰姿势和直立性BP变化之间的可能关系。METHODS研究参与者包括1,992名老年人。通过坐位测量收缩压计算立位血压变化，并在站立后1分钟和3分钟再次测量收缩压。通过在皮肤表面上沿着脊柱引导SpinalMouse装置来评估脊柱对准和弯曲。站立位时的平均腰椎前凸为13.4° ± 12.4°。直立性高血压患者的腰椎前凸程度（收缩压变化，≥+20 mm Hg：3.3° ± 15.6°，≥+10 mm Hg：10.4° ± 14.3°）显著小于直立性正常血压患者（14.2° ± 11.9°）。多元线性回归分析表明，腰椎前凸（β=-0.171，P < 0.001）和胸椎后凸（β= 0.062，P = 0.007），而不是骶骨倾斜（β= 0.033，P = 0.303），是直立位血压变化的独立决定因素。由于腰围是另一个独立的决定因素，直立性高血压的发生率随着腹型肥胖和腰椎前凸程度的增加而线性增加（对照组：9.9%，腹型肥胖：17.4%，腰椎前凸程度：19.4%，两者均为：24.1%，P < 0.001）。受试者在站立后持续直立性高血压3分钟的腰椎前凸程度最小（5.2° ± 16.4°）。
BACKGROUNDOrthostatic hypertension was associated with worse cardiovascular outcomes, although the factors responsible for an orthostatic rise in blood pressure (BP) are uncertain. We investigated a possible relationship between a stooping posture and orthostatic BP change.METHODSStudy participants consisted of 1,992 older individuals. Orthostatic BP change was calculated by systolic BP measured at sitting position, and again 1 and 3 minutes after standing up. Spinal alignment and curvature was assessed by guiding the SpinalMouse device on the surface of the skin along the spine.RESULTSMean lumbar lordosis at standing position was 13.4° ± 12.4°. The degree of lumbar lordosis was significantly smaller in orthostatic hypertensive individuals (systolic BP change, ≥+20 mm Hg: 3.3° ± 15.6°, ≥+10 mm Hg: 10.4° ± 14.3°) than in individuals who were orthostatic normotensive (14.2° ± 11.9°). Multiple linear regression analysis identified lumbar lordosis (β= −0.171,P< 0.001) and thoracic kyphosis (β= 0.062,P= 0.007), but not sacral inclination (β= 0.033,P= 0.303), as independent determinants for orthostatic BP change. As waist circumference was another independent determinant, the frequency of orthostatic hypertensive individuals was linearly increased with the combination of abdominal obesity and small degree of lumbar lordosis (control: 9.9%, abdominal obesity: 17.4%, small degree of lordosis: 19.4%, both: 24.1%,P< 0.001). Participants who sustained orthostatic hypertension for 3 minutes after standing up had the smallest degree of lumbar lordosis (5.2° ± 16.4°).CONCLUSIONStooped posture was an overlooked determinant for orthostatic increases in BP.
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影响因子：
8.3
作者：
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DOI：
--
发表时间：
2015
期刊：
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