This review summarizes the current literature on the epidemiology of orthostatic hypotension (OH) in the elderly and in patients with autonomic impairment also known as neurogenic OH (nOH); these two conditions have distinct pathophysiologies and affect different patient populations. The prevalence of OH in the elderly varies depending on the study population. In community dwellers, OH prevalence is estimated at 16%, whereas in institutionalized patients, it may be as high as 60%. The prevalence of OH increases exponentially with age, particularly in those 75 years and older. Multiple epidemiological studies have identified OH as a risk factor for all-cause mortality and cardiovascular disease including heart failure and stroke. Real-world data from administrative databases found polypharmacy, multiple co-morbid conditions, and high health-care utilization as common characteristics in OH patients. A comprehensive evaluation of medications associated with OH is discussed with particular emphasis on the use of anti-hypertensive therapy from two large clinical trials on high-intensive versus standard blood pressure management. Finally, we also review the epidemiology of nOH based on the underlying neurodegenerative disorder (either Parkinson's disease or multiple system atrophy), and the presence of co-morbid conditions such as hypertension and cognitive impairment.

中文翻译：

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体位性低血压的发病率和死亡率

本综述总结了目前有关老年人和自主神经功能障碍患者体位性低血压 (OH) 流行病学的文献，也称为神经源性低血压 (nOH)；这两种情况具有不同的病理生理学并影响不同的患者群体。老年人 OH 的患病率因研究人群而异。在社区居民中，OH 患病率估计为 16%，而在住院患者中，可能高达 60%。OH 的患病率随着年龄的增长呈指数增长，尤其是在 75 岁及以上的人群中。多项流行病学研究已将 OH 确定为全因死亡率和心血管疾病（包括心力衰竭和中风）的危险因素。来自行政数据库的真实世界数据发现多种药物、多种共病状况、OH 患者的共同特征是医疗保健利用率高。讨论了与 OH 相关的药物的综合评估，特别强调了来自两个关于高强度与标准血压管理的大型临床试验的抗高血压治疗的使用。最后，我们还根据潜在的神经退行性疾病（帕金森病或多系统萎缩）以及高血压和认知障碍等合并症的存在，回顾了 nOH 的流行病学。