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Orthostatic Hypertension
Hypertension ( IF 8.3 ) Pub Date : 2020-05-01 , DOI: 10.1161/hypertensionaha.120.14340 Jens Jordan 1, 2 , Fabrizio Ricci 3, 4 , Fabian Hoffmann 1, 2 , Viktor Hamrefors 3, 5 , Artur Fedorowski 3, 6
Hypertension ( IF 8.3 ) Pub Date : 2020-05-01 , DOI: 10.1161/hypertensionaha.120.14340 Jens Jordan 1, 2 , Fabrizio Ricci 3, 4 , Fabian Hoffmann 1, 2 , Viktor Hamrefors 3, 5 , Artur Fedorowski 3, 6
Affiliation
Orthostatic hypertension, which appears to be mediated through excess neurohumoral activation while standing, is a common blood pressure trait among patients with and without arterial hypertension. However, lack of consensus regarding the definition of orthostatic hypertension makes it difficult to assess the true prevalence of this condition. Orthostatic hypertension appears to predict the risk for progression to arterial hypertension in younger and risk of cardiovascular morbidity and mortality in older persons. Yet, the risk may differ between populations. Whether orthostatic hypertension indicates a generally increased risk of death, constitutes an intermediate variable in the causal pathway of cardiovascular risk factors, a simple measure of disease severity, or an independently acting mechanism is not known. Since both orthostatic hypotension and orthostatic hypertension herald increased risk of cardiovascular disease, it appears reasonable to screen the patients for abnormal orthostatic blood pressure responses using simple orthostatic testing. However, how presence of orthostatic hypertension may affect clinical management decisions such as the choice of antihypertensive drugs is currently difficult to ascertain. Clearly, this issue deserves more attention.
中文翻译:
体位性高血压
直立性高血压似乎是通过站立时过度的神经体液激活介导的,是患有和不患有动脉高血压的患者的常见血压特征。然而,由于对直立性高血压的定义缺乏共识,因此很难评估这种情况的真实患病率。体位性高血压似乎可以预测年轻人进展为动脉高血压的风险以及老年人心血管发病率和死亡率的风险。然而,风险可能因人群而异。直立性高血压是否表明死亡风险普遍增加,是心血管危险因素因果途径中的中间变量,是疾病严重程度的简单衡量标准,还是独立作用机制尚不清楚。由于体位性低血压和体位性高血压都预示着心血管疾病的风险增加,因此使用简单的体位性测试筛查患者的体位性血压异常反应似乎是合理的。然而,直立性高血压的存在如何影响临床管理决策,例如抗高血压药物的选择,目前难以确定。显然,这个问题值得更多关注。
更新日期:2020-05-01
中文翻译:
体位性高血压
直立性高血压似乎是通过站立时过度的神经体液激活介导的,是患有和不患有动脉高血压的患者的常见血压特征。然而,由于对直立性高血压的定义缺乏共识,因此很难评估这种情况的真实患病率。体位性高血压似乎可以预测年轻人进展为动脉高血压的风险以及老年人心血管发病率和死亡率的风险。然而,风险可能因人群而异。直立性高血压是否表明死亡风险普遍增加,是心血管危险因素因果途径中的中间变量,是疾病严重程度的简单衡量标准,还是独立作用机制尚不清楚。由于体位性低血压和体位性高血压都预示着心血管疾病的风险增加,因此使用简单的体位性测试筛查患者的体位性血压异常反应似乎是合理的。然而,直立性高血压的存在如何影响临床管理决策,例如抗高血压药物的选择,目前难以确定。显然,这个问题值得更多关注。