Symptomatic orthostatic hypotension in Parkinson's disease patients: Prevalence, associated factors and its impact on balance confidence
Symptomatic orthostatic hypotension in Parkinson's disease patients: Prevalence, associated factors and its impact on balance confidence
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DOI：
10.1016/j.jns.2017.12.037
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发表时间：
2018-02-15
影响因子：
4.4
通讯作者：
Bhidayasiri, Roongroj
中科院分区：
文献类型：
--
作者：
Klanbut, Siranan;Phattanarudee, Siripan;Bhidayasiri, Roongroj
背景资料：体位性低血压是帕金森病（PD）患者心血管自主神经功能障碍的常见表现。患者可能患有各种各样的OH的临床症状，包括头晕，头晕，或视力和fatigue.Objectives问题：确定帕金森病（PD）中症状性直立性低血压（OH）的患病率和相关因素，并确定OH的临床症状和平衡信心之间的任何关系。OH症状定义为站立3分钟内收缩压或舒张压分别下降≥ 20或≥ 10 mmHg，直立性低血压问卷（OHQ）评分大于零。通过多因素Logistic回归分析确定与症状性OH相关的因素。Pearson相关性检验被用来揭示OH的临床症状和患者的信心，在他们的平衡能力之间的任何关系，评估使用活动特定的平衡信心（ABC）scale.Results：100泰国PD患者被连续招募到这项研究。有症状OH的患病率为18%，无症状OH为4%，而78%的患者没有OH。与症状性OH相关的因素是年龄（OR，95%CI：1.06，1.003-1.115，p = 0.038）和高血压（OR，95%CI：6.16，1.171-32.440，p = 0.032）。一个显着的和负相关（r = 0.229，p = 0.022）OHQ综合评分和项目3的ABC量表（从地板上捡拖鞋），在垂直方向的运动之一，被发现。结论：老年PD患者和原发性高血压的合并症应密切评估存在症状OH。此外，应建议他们慢慢改变姿势，特别是垂直方向的姿势。
Background: Orthostatic hypotension (OH) is a commonly reported sign of the cardiovascular autonomic dysfunctions associated with Parkinson's disease (PD). Patients might suffer from a variety of the clinical symptoms of OH, including dizziness, lightheadedness, or problems with vision and fatigue.Objectives: To determine the prevalence of, and factors associated with, symptomatic orthostatic hypotension (OH) in Parkinson's disease (PD) and to identify any relationships between the clinical symptoms of OH and balance confidence in this patient population.Methods: Symptomatic OH was defined as a systolic or diastolic BP fall of >= 20 or >= 10 mmHg respectively, within 3 min of standing and an Orthostatic Hypotension Questionnaire (OHQ) score of more than zero. Factors related to symptomatic OH were identified from a multivariate logistic regression analysis. Pearson's correlation test was used to reveal any relationships between the clinical symptoms of OH and a patient's confidence in their ability to balance, assessed using the Activities-specific Balance Confidence (ABC) scale.Results: 100 Thai PD patients were consecutively recruited into this study. The prevalence of symptomatic OH was 18%, asymptomatic OH was 4%, while 78% were patients without OH. Factors associated with symptomatic OH were age (OR, 95%CI: 1.06, 1.003-1.115, p = 0.038) and hypertension (OR, 95%CI: 6.16, 1.171-32.440, p = 0.032). A significant and negative correlation (r = 0.229, p = 0.022) between OHQ composite scores and item 3 of the ABC scale (picking up slippers from floor), one of the movements in a vertical orientation, was found.Conclusion: Elderly PD patients and with a co-morbidity of essential hypertension should be closely evaluated for the presence of symptomatic OH. In addition, they should be advised to change positions slowly, especially those in a vertical orientation.