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Differential diagnosis of orthostatic hypotension
Autonomic Neuroscience ( IF 3.2 ) Pub Date : 2020-11-01 , DOI: 10.1016/j.autneu.2020.102713
Lucy Y Lei 1 , Derek S Chew 2 , Satish R Raj 3
Affiliation  

Orthostatic hypotension (OH) is a common clinical manifestation characterized by a significant fall in blood pressure with postural change and is frequently accompanied by debilitating symptoms of orthostatic intolerance. The reported prevalence of OH ranges between 5 and 10% in middle-aged adults with a burden that increases concomitantly with age; in those over 60 years of age, the prevalence is estimated to be over 20%. Unfortunately, the clinical course of OH is not necessarily benign. OH patients are at an increased risk of adverse clinical outcomes including death, falls, cardiovascular and cerebrovascular events, syncope, and impaired quality of life. The differential diagnosis of OH is broad and includes acute precipitants as well as chronic underlying medical conditions, especially of neurological origin. Appropriate diagnosis relies on a systematic history and physical examination with particular attention to orthostatic vital signs, keeping in mind that ambient conditions during diagnostic testing may affect OH detection due to factors such as diurnal variation.

中文翻译:

体位性低血压的鉴别诊断

直立性低血压 (OH) 是一种常见的临床表现,其特征是血压随着体位变化而显着下降,并且经常伴有直立性不耐受的虚弱症状。据报道,中年人的 OH 患病率在 5% 到 10% 之间,其负担随着年龄的增长而增加;在 60 岁以上的人群中,估计患病率超过 20%。不幸的是,OH 的临床过程不一定是良性的。OH 患者出现不良临床结果的风险增加,包括死亡、跌倒、心脑血管事件、晕厥和生活质量受损。OH 的鉴别诊断范围很广,包括急性诱发因素和慢性基础疾病,尤其是神经系统疾病。
更新日期:2020-11-01
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