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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Impaired Systolic Blood Pressure Recovery Directly After Standing Predicts Mortality in Older Falls Clinic Patients
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Impaired Systolic Blood Pressure Recovery Directly After Standing Predicts Mortality in Older Falls Clinic Patients

机译：站立后直接预测老年跌倒临床患者的死亡率，收缩压恢复直接受损

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Background. Normally, standing up causes a blood pressure (BP) drop within 15 seconds, followed by recovery to baseline driven by BP control mechanisms. The prognostic value of this initial BP drop, but also of the recovery hereafter, is unknown. The aim of this study was to examine the prognostic value of these BP characteristics in response to standing. Methods. In a retrospective cohort study of 238 consecutive patients visiting our falls outpatient clinic, we examined the relation between all-cause mortality and BP decline and recovery directly after active standing up with Cox proportional hazards analyses. Results. Of 238 patients (mean age 78.4 ±7.8 years), during a median follow-up of 21.0 months, 36 (15%) patients died. Neither absolute nor relative (%) initial BP drop after standing predicted mortality. In contrast, the magnitude of BP recovery 40-60 seconds after standing was associated with mortality, even after adjustment for age, comorbid-ity, and other baseline characteristics. When systolic BP had recovered to less than 80% of prestanding baseline after 60 seconds of standing, this was a powerful independent predictor of mortality (hazard ratio: 3.00; 95% confidence interval 1.17-7.68). Conclusions. Failure to recover from BP decline in the first minute after active standing up is associated with excess mortality in falls clinic patients. A recovery of systolic BP to less than 80% of baseline after 60 seconds may be used as an easily available cardiovascular marker for increased mortality risk in older falls clinic patients.
机译：背景。通常，站立会导致血压（BP）在15秒内下降，然后由BP控制机制驱动恢复到基线。最初的BP下降的预后价值，以及此后恢复的预后价值均未知。这项研究的目的是检查这些血压特征对站立的预后价值。方法。在一项对238名连续跌倒门诊就诊的连续患者的回顾性队列研究中，我们通过Cox比例风险分析直接检查了主动站立后全因死亡率与BP下降和恢复之间的关系。结果。在238位患者（平均年龄78.4±7.8岁）中，在21.0个月的中位随访期间，有36位（15％）患者死亡。站立预测的死亡率后，绝对或相对（％）的初始血压均未下降。相反，站立后40-60秒的BP恢复幅度与死亡率相关，即使在调整了年龄，合并症和其他基线特征后也是如此。站立60秒后，收缩压恢复到低于基线的80％，这是死亡率的有力独立预测指标（危险比：3.00; 95％置信区间1.17-7.68）。结论。主动站立后第一分钟未能从血压下降中恢复，这与跌倒诊所患者的死亡率过高有关。 60秒钟后收缩压恢复至基线的80％以下可作为容易获得的心血管标志物，以增加老年跌倒临床患者的死亡风险。

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