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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Geriatric hypotensive syndromes are not explained by cardiovascular autonomic dysfunction alone
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Geriatric hypotensive syndromes are not explained by cardiovascular autonomic dysfunction alone

机译：单凭心血管自主神经功能障碍不能解释老年性高血压综合征

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Background. Though highly prevalent, the pathophysiology of orthostatic hypotension (OH), postprandial hypotension (PPH), and carotid sinus hypersensitivity (CSH) are rarely studied together. Therefore, we conducted such a comprehensive study focusing on the common role of the cardiovascular autonomic system. We hypothesized that in geriatric patients, OH, PPH, and CSH are manifestations of cardiovascular autonomic dysfunction and investigated state-of-the-art cardiovascular autonomic function indices in a group of geriatric falls or syncope patients.Methods. In a cross-sectional study of 203 consecutive eligible falls clinic patients, we compared heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) as potential autonomic function determinants of the three different hypotensive syndromes.Results. OH, PPH, and CSH were diagnosed in 53%, 57%, and 50% of the patients, respectively. In a population relevant for geriatric practice, we found no differences in HRV, BPV, and BRS between patients with and without OH, with and without PPH, and with and without CSH, respectively, nor between patients with and without falls, dizziness, or syncope as presenting symptom, respectively.Conclusions. In geriatric patients with hypotensive syndromes, cardiovascular autonomic function as measured by HRV, BPV, and BRS is comparable to patients without such syndromes. These findings argue against a single or dominant etiological factor, that is, cardiac autonomic dysfunction and underline the structured, broad, and multifactorial approach to elderly patients with falls and/or syncope as proposed in the current evidence-based syncope guidelines.
机译：背景。虽然高度流行，但是体位性低血压（OH），餐后低血压（PPH）和颈动脉窦超敏反应（CSH）的病理生理学很少一起研究。因此，我们针对心血管自主系统的共同作用进行了如此全面的研究。我们假设在老年患者中，OH，PPH和CSH是心血管自主神经功能障碍的表现，并研究了一组老年跌倒或晕厥患者的最新心血管自主神经功能指标。在一项对203位连续合格的跌倒门诊患者进行的横断面研究中，我们比较了心率变异性（HRV），血压变异性（BPV）和压力反射敏感性（BRS）作为三种不同的低血压综合征潜在的自主神经功能决定因素。 OH，PPH和CSH分别被诊断为53％，57％和50％的患者。在与老年医学相关的人群中，我们发现有和没有OH，有和没有PPH，有和没有CSH的患者之间，以及有和没有跌倒，头晕或晕厥分别表现为症状。在患有低血压综合征的老年患者中，通过HRV，BPV和BRS测得的心血管自主功能与没有此类综合征的患者相当。这些发现与单一的或主要的病因有关，即心脏自主神经功能障碍，并强调了现行的基于证据的晕厥指南中提出的针对患有跌倒和/或晕厥的老年患者的结构化，广泛性和多因素方法。

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