目的：探讨老年人餐后低血压（ PPH ）的临床特点和影响因素。方法该院心血管门诊患者273例，按年龄大小分为高龄组（≥80岁）96例，普通组（60～80岁）177例，给予标准化的餐饮方案。采用24 h动态血压监测仪测定患者右上肢血压，每隔30 min检测一次。同时记录患者的身高、体重等基本资料，以及患者的基础疾病和用药情况。比较分析不同情况下两组患者的PPH检出率及药物等因素的影响。结果高龄组的高血压及心脑血管事件发生率明显高于普通组（ P＜0.01）。高龄组早、中、晚餐后PPH检出率均显著高于普通组（ P＜0.01）；且三餐后血压降低幅度均大于普通组，但只有中餐后有统计学差异（ P＜0.01）。对于应用利尿剂和硝酸酯类降压药的老年人，高龄组 PPH发生率显著高于普通组（P＜0.01，P＜0.05）。年龄、高血压、降压药与PPH正相关。结论高龄老年人PPH的发生率高于普通老年人，且血压降低幅度较大；利尿剂和硝酸酯类降压药可增加高龄老年人PPH的发生率；高血压、降压药可影响PPH的检出率。%Objective To investigate the clinical characteristics and influencing factors of the elderly postprandial hypotension (PPH).Methods 273 cases of patients were divided into two groups according to their age,with 96 cases in elder group(>80 years old) and 177 cases in normal group (60~80 years old).Blood pressures were determined by 24-hour ambulatory monitoring in patients with right upper limb,once every 30 minutes.At the same time,the patient's basic information such as height,weight and medications were recorded. Results The occurrence rate of hypertension and cardiovascular and cerebrovascular events in elder group were significantly higher than those of normal group (P<0.01).The rates of PPH in elder group were significantly higher than those of normal group after breakfast,lunch and dinner (P<0.01);while rang of elder group were also greater than those of normal group,but there was only a significant change after lunch(P<0.05).For application of diuretics and nitric acid ester,the incidence of PPH in elder group was higher than that of normal group ( P<0.01,P<0.05).Age,hypertension,drugs were related with the rate of PPH.Conclusions The incidence of PPH and decreased range in the elderly are higher than those of ordinary old people,while diuretics and nitric acid ester antihypertensive agents could increase the inci-dence of PPH in the elderly.In addition,hypertension and drugs are related with the rate of PPH.
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