Ортостатические гипотензивные реакции у больных пожилого и старческого возраста с артериальной гипертонией

Автор: Атюнина И.В., Ощепкова Е.В., Рогоза А.Н.

Журнал: Евразийский кардиологический журнал @eurasian-cardiology-journal

Рубрика: Обзор

Статья в выпуске: 4, 2020 года.

Бесплатный доступ

Известно, что частота ортостатических гипотензивных реакций (ОГР) увеличивается с возрастом и нередко встречается у лиц пожилого и старческого возраста с артериальной гипертонией (АГ), негативно влияя на качество их жизни. Большое количество исследований указывают на связь ОГР с повышенным риском сердечно-сосудистых осложнений, когнитивных нарушений и смертности, особенно для лиц среднего возраста и пожилых (до 65 лет). Прогностическая роль ОГР для больных АГ более старшего возраста в настоящее время является неопределенной. Кроме того, сохраняется еще ряд нерешенных вопросов, касающихся выявления ОГР у этой категории больных и определения тактики лечения. В данном обзоре представлена современная классификация ортостатических гипотензивных реакций и особенности их клинических проявлений у пожилых больных с АГ. Особое внимание уделено анализу результатов исследований о прогностической роли ОГР при АГ в повышении риска развития коронарных, цереброваскулярных осложнений и когнитивных нарушений. Рассмотрены особенности антигипертензивной терапии у больных АГ с ОГР, а также представлены современные рекомендации по медикаментозным и немедикаментозным методам лечения ОГР.

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Ортостатическая гипотензия, артериальная гипертония, пожилые

Короткий адрес: https://sciup.org/143173307

IDR: 143173307 | DOI: 10.38109/2225-1685-2020-4-52-63

Список литературы Ортостатические гипотензивные реакции у больных пожилого и старческого возраста с артериальной гипертонией

The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 1996; 46: 1470. DOI: 10.1007/s10286-011-0119-5
Wieling W, Krediet CT, van Dijk N, Linzer M, Tschakovsky ME. Initial orthostatic hypotension: review of a forgotten condition. ClinSci (Lond). 2007 Feb;112(3):157-65. DOI: 10.1042/CS20060091
Brignole M, Moya A, de Lange FJ et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur. Heart J 2018. DOI: 10.1093/eurheartj/ehy037
Рогоза А.Н., Ощепкова Е.В., Певзнер А.В., Кузьмина Ю.В. Варианты ортостатической гипотонии. Новые классификации и методы выявления. Терапевтический архив. 2012. Т. 84. №4. C. 46-51.
Imholz B. P, Dambrink J.H., Karemaker J.M., Wieling W. Orthostatic circulatory control in the elderly evaluated by non-invasive continuous blood pressure measurement. ClinSci (Lond). 1990 Jul; 79(1):73-9. 10.1042/cs0790073. PMID: 2167794. DOI: 10.1042/cs0790073.PMID
Romero-Ortuno R., Cogan L., Foran T. et al. Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people. J. Am. Geriatr. Soc. 2011; 59 (4): 655-665.
DOI: 10.1111/j.1532-5415.2011.03352.x
Streeten D.H, Anderson GH, Jr. Delayed orthostatic intolerance. Arch Intern Med. 1992; 152:1066-72.
Fedorowski A, Melander O. Syndromes of orthostatic intolerance: a hidden danger. J Intern Med. 2013;273:322-335.
DOI: 10.1111/joim.12021
Freeman R., Abuzinadah A.R., Gibbons C., Jones P., Miglis M.G., Sinn D.I. Orthostatic Hypotension: JACC State-of-the-Art Review. J Am Coll Cardiol. 2018;72(11):1294-1309.
DOI: 10.1016/j.jacc.2018.05.079
Fedorowski A., Stavenow L., Hedblad B., et al. Orthostatic hypotension predicts all-cause mortality and coronary events in middle-aged individuals (The Malmo Preventive Project). Eur. Heart J. 2010; 31: 85-91.
DOI: 10.1093/eurheartj/ehp329
I. Tzur, S. Izhakian, O. Gorelik. Orthostatic hypotension in internal medicine wards. Curr Med Res Opin 2018.
DOI: 10.1080/03007995.2018.1546679
C Feldstein, A.B. Weder. Orthostatic hypotension: a common, serious and underrecognized problem in hospitalized patients. J Am Soc Hypertens. 2012; 6: 27-39.
DOI: 10.1016/j.jash.2011.08.008
P.A. Low Prevalence of orthostatic hypotension. Clin Auton Res 2008; 18 (Suppl 1):8-13.
DOI: 10.1007/s10286-007-1001-3
E. Grossman Orthostatic hypotension: Is it a predictor of total and cardiovascular mortality in the elderly? Journal of Hypertension, 2019; 37(2), 284-286.
DOI: 10.1097/hjh.0000000000001919
R. Pop-Busui, W.H. Herman, E.L. Feldman, et al., for the DCCT/EDIC Research Group DCCT and EDIC studies in type 1 diabetes: lessons for diabetic neuropathy regarding metabolic memory and natural history. Curr Diab Rep, 2010; 10, pp. 276-282.
DOI: 10.1007/s11892-010-0120-8
F. Geser, K. Seppi, M. Stampfer-Kountchev, et al., for the EMSA-SG. The European Multiple System Atrophy-Study Group (EMSA-SG). J Neural Transm (Vienna). 2005 Dec;112(12):1677-86.
DOI: 10.1007/s00702-005-0328-y
P.A. Low, S.G. Reich, J. Jankovic, et al. Natural history of multiple system atrophy in the USA: a prospective cohort study Lancet Neurol. 2015 Jul;14(7):710-9.
DOI: 10.1016/S1474-4422(15)00058-7
Applegate W.B., Davis B.R., Black H.R. et al. Prevalence of postural hypotension at baseline in the Systolic Hypertension in the Elderly Program (SHEP) cohort. J. Am. Geriatr. Soc.,1991; 39, 1057-1064.
DOI: 10.1111/j.1532-5415.1991.tb02869.x
R. Freeman, W. Wieling, F.B. Axelrod et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin. Auton Res 2011; 21: 69-72.
DOI: 10.1007/s10286-011-0119-5
MDL O'Connell, G.M. Savva, C.W. Fan, R.A. Kenny. Orthostatic hypotension, orthostatic intolerance and frailty: The Irish Longitudinal Study on Aging TILDA. Arch Gerontol Geriatr. 2015 May-Jun; 60(3):507-13.
DOI: 10.1016/j.archger.2015.01.008
D. J. L. Van Twist., T. Dinh, E. M. E. Bouwmans, & A. A. Kroon. Initial orthostatic hypotension among patients with unexplained syncope: An overlooked diagnosis? International Journal of Cardiology, 2018; 271, 269-273.
DOI: 10.1016/j.ijcard.2018.05.043
C.H. Gibbons, R. Freeman. Clinical implications of delayed orthostatic hypotension: a 10-year follow-up study. Neurology. 2015; 85:1362-7.
DOI: 10.1212/WNL.0000000000002030
P. Torabi, F. Ricci, V. Hamrefors, R. Sutton, A. Fedorowski. Classical and Delayed Orthostatic Hypotension in Patients with Unexplained Syncope and Severe Orthostatic Intolerance. Front. Cardiovasc. Med. 2020; 7:21. Published 2020 Feb 21.
DOI: 10.3389/fcvm.2020.00021
K.M. Rose, M.L. Eigenbrodt, R.L. Biga, D.J. Couper, K.C. Light, A.R. Sharrett, G. Heiss. Orthostatic hypotension predicts mortality in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) study. Circulation 2006; 114:630-636.
DOI: 10.1161/CIRCULATIONAHA.105.598722
J.L. Fleg, G.W. Evans, K.L. Margolis, J. Barzilay, J.N. Basile, J.T. Bigger, et al. Orthostatic hypotension in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) blood pressure trial: prevalence, incidence, and prognostic significance. Hypertension 2016; 68:888-895.
DOI: 10.1161/HYPERTENSIONAHA.116.07474
F. Ricci, A. Fedorowski, F. Radico, M. Romanello, A. Tatasciore, M. Di Nicola, et al. Cardiovascular morbidity and mortality related to orthostatic hypotension: a meta-analysis of prospective observational studies. EurHeart J 2015; 36:1609-1617.
DOI: 10.1093/eurheartj/ehv093
A. Weiss, Y. Beloosesky, R. Kornowski, A. Yalov, J. Grinblat, E. Grossman. Influence of orthostatic hypotension on mortality among patients discharged from an acute geriatric ward. J Gen Intern Med. 2006;21(6):602-606.
DOI: 10.1111/j.1525-1497.2006.00450.x
A. Szyndler, T. Dereziński, J. Wolf, K. Narkiewicz. Impact of orthostatic hypotension and antihypertensive drug treatment on total and cardiovascular mortality in a very elderly communitydwelling population. J Hypertens. 2019;37(2):331-338.
DOI: 10.1097/HJH.0000000000001878
M. Bursztyn, J.M. Jacobs, A. Hammerman-Rozenberg, J. Stessman. Prevalence of orthostatic hypertension in the very elderly and its relationship to all-cause mortality. J Hypertens 2016; 34:2053-2058.
DOI: 10.1097/HJH.0000000000001044
I. Tzur, S. Izhakian, O. Gorelik. Orthostatic hypotension: definition, classification and evaluation. Blood Press. 2019; 28(3):146-156.
DOI: 10.1080/08037051.2019.1604067
G.C.Verwoert, F.U.Mattace-Raso, A.Hofman et al. Orthostatic hypotension and risk of cardiovascular disease in elderly people: the Rotterdam study. J Am Geriatr Soc. 2008; 56(10):1816-20.
DOI: 10.1111/j.1532-5415.2008.01946.x
A.Fedorowski, B.Hedblad, O. Melander. Early postural blood pressure response and cause-specific mortality among middle-aged adults. Eur J Epidemiol. 2011;26(7):537-46.
DOI: 10.1007/s10654-11-9578-1
W. Xin, S. Mi, Z. Lin, H. Wang, W. Wei. Orthostatic hypotension and the risk of incidental cardiovascular diseases: a meta-analysis of prospective cohort studies. PrevMed 2016; 85:90-97.
DOI: 10.1016/j.ypmed.2016.01.007
A. Fedorowski, B. Wahlstrand, T. Hedner, O. Melander. Systolic and diastolic component of orthostatic hypotension and cardiovascular events in hypertensive patients: the Captopril Prevention Project. J Hypertens. 2014; 32: 75-81.
DOI: 10.1097/hjh.0b013e328365cd59
K. Hosokawa, T. Ide, T.Tobushi, et al. Bionic baroreceptor corrects postural hypotension in rats with impaired baroreceptor. Circulation,2012; 126, 1278-1285.
DOI: 10.1161/CIRCULATIONAHA.112.108357
S. Simula, T. Laitinen, E. Vanninen et al. Baroreflex sensitivity in asymptomatic coronary atherosclerosis. Clin. Physiol. Funct. Imaging2013; 33, 70-74.
DOI: 10.1111/j.1475-097X.2012.01165.x
N. Okada., N. Takahashi, K. Yufu, et al. Baroreflex sensitivity predicts cardiovascular events in patients with type 2 diabetes mellitus without structural heart disease. Circ. J, 2010; 74, 1379-1383.
DOI: 10.1253/circj.cj-09-0960
G.M. De Ferrari, A. Sanzo, A. Bertoletti, G. Specchia, E. Vanoli, P.J. Schwartz. Baroreflex sensitivity predicts long-term cardiovascular mortality after myocardial infarction even in patients with preserved left ventricular function. J. Am. Coll. Cardiol. 2007; 50, 2285-2290.
DOI: 10.1016/j.jacc.2007.08.043
M. Sykora, J. Diedler, A. Rupp, P. Turcani, T. Steiner. Impaired baroreceptor reflex sensitivity in acute Stroke is associated with insular involvement, but not with carotid atherosclerosis. Stroke 2009; 40, 737-742.
DOI: 10.1161/STROKEAHA.108.519967
T. Hayakawa, C.A. McGarrigle, R.F. Coen, C.J. Soraghan, T. Foran, B.A. Lawlor, R.A. Kenny (2015). Orthostatic blood pressure behavior in people with mild cognitive impairment predicts conversion to dementia. J AmGeriatrSoc 63:1868-1873.
DOI: 10.1111/jgs.13596
V. Gupta, L.A. Lipsitz. Orthostatic hypotension in the elderly: diagnosis and treatment. Am J Med. 2007; 120(10):841-7.
DOI: 10.1016/j.amjmed.2007.02.023
R. Peters, K.J. Anstey, A. Booth et al. Orthostatic hypotension and symptomatic subclinical orthostatic hypotension increase risk of cognitive impairment: an integrated evidence review and analysis of a large older adult hypertensive cohort. Eur Heart J. 2018 Sep 1;39 (33):3135-3143.
DOI: 10.1093/eurheartj/ehy418
M.A. Binnewjizend, J.P. Kuijer, MR Benedictus et al. Cerebral blood flow measured with 3D pseudocontinuous arterial spin-labeling MR imaging in Alzheimer disease and mild cognitive impairment: A marker for disease severity. Radiology. 2013 Apr;267(1):221-30.
DOI: 10.1148/radiol.12120928
A.J. Espay, P.A. LeWitt, R.A. Hauser, A. Merola, M. Masellis, A.E. Lang. Neurogenic orthostatic hypotension and supine hypertension in Parkinson's disease and related synucleinopathies: prioritisation of treatment targets. Lancet Neurol 2016; 15:954-966.
DOI: 10.1016/S1474-4422(16)30079-5
G. Ravaglia, P. Forti, F. Maioli et al. Screening for mild cognitive impairment in elderly ambulatory patients with cognitive complaints. Aging ClinExp Res 2005; 17: 374-9. Novak V, Hajjar I. The relationship between blood pressure and cognitive function. Nat Rev Cardiol. 2010;7(12):686-698.
DOI: 10.1038/nrcardio.2010.161
Атюнина И.В., Ощепкова Е.В., Рогоза А.Н., Лазарева Н.В. Ортостатические реакции и когнитивные дисфункции у больных артериальной гипертонией пожилого и старческого возраста. Системные гипертензии. 2019; 16 (2): 47-53.
DOI: 10.26442/2075082X.2019.2.190357
Joseph A, Wanono R, Flamant M, Vidal-Petiot E. Orthostatic hypotension: A review. Nephrol Ther. 2017 Apr;13 Suppl 1:S55-S67.
DOI: 10.1016/j.nephro.2017.01.003
Allan L.M., Ballard C.G., Allen J., et al. Autonomic dysfunction in dementia. J Neurol. Neurosurg Psychiatry. 2007;78 (7):671-677.
DOI: 10.1136/jnnp.2006.102343
Poon I.O., Braun U. High prevalence of orthostatic hypotension and its correlation with potentially causative medications among elderly veterans. J ClinPharmTher 2005; 30:173-178.
DOI: 10.1111/j.1365-2710.2005.00629.x
Kamaruzzaman S., Watt H., Carson C., Ebrahim S.. The association between orthostatic hypotension and medication use in the British Women's Heart and Health Study. Age Ageing 2010; 39:51-56.
DOI: 10.1093/ageing/afp192
Berganzo K, Díez-Arrola B, Tijero B, et al. Nocturnal hypertension and dysautonomia in patients with Parkinson's disease: are they related? J Neurol. 2013;260 (7):1752-1756.
DOI: 10.1007/s00415-013-6859-5
Lee T., Donegan C., Moore A. Combined hypertension and orthostatic hypotension in older patients: a treatment dilemma for clinicians. Expert Rev Cardiovasc Ther. 2005 May; 3(3):433-40.
DOI: 10.1586/14779072.3.3.433
Juraschek S.P., Simpson L.M., Davis B.R., Beach J.L., Ishak A., Mukamal K.J. Effects of Antihypertensive Class on Falls, Syncope, and Orthostatic Hypotension in Older Adults: The ALLHAT Trial. Hypertension. 2019;74(4):1033-1040.
DOI: 10.1161/HYPERTENSIONAHA.119.13445
Williamson J.D, Supiano M.A, Applegate W.B., et al; SPRINT Research Group. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years: a randomized clinical trial. JAMA. 2016;315:2673-2682. 10.1001/JAMA. 2016.7050.
DOI: 10.1001/jama.2016.7050
Williams B., Mancia G., Spiering W., AgabitiRosei E., Azizi M., Burnier M. et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension. EurHeart J. 2018;39 (33):3021-3104.
DOI: 10.1093/eurheartj/ehy339
Gangavati A., Hajjar I., Quach L., Jones R.N., Kiely D.K., Gagnon P., et al. Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. J AmGeriatrSoc 2011;59(3):383-9.
DOI: 10.1111/j.1532-5415.2011.03317.x
Атюнина И.В., Ощепкова Е.В., Рогоза А.Н. Особенности церебральной ауторегуляции и реактивности у больных артериальной гипертонией старших возрастных групп с ортостатическими гипотензивными реакциями. Системные гипертензии. 2020; 17 (2).
DOI: 10.26442/2075082X.2020.2.200214
Rutan G.H, Hermanson B., Bild D.E., Kittner S.J., LaBaw F., Tell G.S. Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group. Hypertension. 1992;19 (6 Pt 1):508-519.
DOI: 10.1161/01.hyp.19.6.508
Чазова И.Е., Жернакова Ю.В. от имени экспертов. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Системные гипертензии. 2019; 16 (1): 6-31.
DOI: 10.26442/2075082X.2019.1.190179
van Lieshout J.J, ten Harkel A.D., Wieling W. Fludrocortisone and sleeping in the head-up position limit the postural decrease in cardiac output in autonomic failure. Clin Auton Res 2000; 10:35-42.
DOI: 10.1007/BF02291388
Аксенова А.В., Гориева Ш.Б., Рогоза А.Н. и др. Современные представления о диагностике и лечении ортостатической гипотензии. Системные гипертензии. 2018; 15 (2): 32-42.
DOI: 10.26442/2075-082X_2018.2.32-42

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