Delayed Orthostatic Hypotension Often Progresses with a High Mortality迟发体位性低血压常有进展且死亡率高

A 10 year follow up study concluded that delayed orthostatic hypotension (OH) frequently progresses to OH with a high associated mortality. The study reviewed the medical records of 230 patients who completed autonomic testing at a single center in the US from January 1, 2002, through December 31, 2003. Forty-eight individuals with delayed OH, 42 individuals with OH, and 75 controls had complete follow-up data. Fifty-four percent of individuals with delayed OH progressed to OH. Thirty-one percent of individuals with delayed OH developed an α-synucleinopathy. The 10-year mortality rate in controls, individuals with delayed OH and baseline OH was 9%, 29% and 64%, respectively. The 10-year mortality of individuals who progressed to OH was 50%. Progression to OH was associated with developing an α-synucleinopathy, baseline diabetes, and abnormal baseline autonomic test results. OH is currently defined as a fall of 20 mm Hg in systolic blood pressure or 10 mm Hg in diastolic pressure within 3 minutes of assuming a standing position. Pressure drops after the 3-minute window is delayed. Source: http://www.neurology.org/一项10年的随访研究得出结论，迟发体位性低血压经常发展为体位性低血压且相关死亡率高。该研究审查了2002年1月1日至2003年12月31日在美国一个医疗中心完成自主（神经功能）测试的230例患者的病历。四十八例迟发体位性低血压，42例体位性低血压，和75例对照患者有完整随访数据。54%的迟发体位性低血压者发展为体位性低血压。31%的迟发体位性低血压者发生α突触核蛋白病。 对照，迟发体位性低血压和基线体位性低血压者10年死亡率分别为9％，29％和64％。进展为体位性低血压者的10年死亡率为50％。进展为体位性低血压与发生α突触核蛋白病，基线糖尿病和异常基线自主测试结果有关。 目前认为体位性低血压为站立位置3分钟内收缩压下降20毫米汞柱或舒张压下降10毫米汞柱。3分钟之后血压下降则为迟发。来源：http://www.neurology.org/