低血压的防治

人体血压有高、有低，不论高低都不好。测量血压时，有低于90／60mmHg，称为低血压。它有三种类型：一、原发性（体重性）低血压；二、特发性（直立性）低血压；三、继发性（直立性）体位性低血压。低血压病因复杂，应经常测量血压，注意防治。     

康博士信箱

低血压怎么突然升高了?康博士:我今年78岁,以前是低血压,这几天血压突然增高,这是怎么回事?山东省烟台市林XX林读者:你首先要测量现在的血压有多高,是属于高血压I期(140~159/90~99mmHg)还是高血压Ⅱ期(>180/110mmHg)。由于天气寒冷,血管处于收缩状态,老年人的血压会适当高一些,这属于正常状态。     

基于脉搏波识别的电子血压计智能充气研究

通过对多款常用的国内外电子血压计的血压实验测试,发现对高血压或低血压情况进行测量时,存在着由于最大充气压力与本次血压测量不符,而带来反复充放气和充气压力过高的问题。为了解决这些问题,找到合适的最大充气压力,提出了两个基于脉搏波识别的智能充气方案,并进行了700组血压实验,对两个方案进行实验验证。实验证明所提出的两个方案具有很好的稳定性以及准确性,可以有效地解决血压计测量中的问题,同时得出了方案二即在充气过程中预估最大充气压力为最优方案。     

老年高血压合并体位性低血压患者靶器官损害及最佳血压水平的研究

目的研究老年高血压合并体位性低血压患者靶器官损害情况及最佳的血压水平。方法选取2010年3月~7月进行体检的长期居住广州的军队离退休老干部中的原发性高血压患者849例,对其进行健康问卷调查,并测量卧位及立位后0、2 min血压和心率,对体位性低血压的发生率进行统计,同时分析体位性低血压组与非体位性低血压组患者靶器官损害情况。结果老年高血压患者体位性低血压的发生率随着高血压分级升高而增加;体位性低血压组的左室肥厚及微量白蛋白尿的发生率均高于非体位性低血压组;血压控制在130~139/70~79 mm Hg时体位性低血压的发生率最低。结论老年高血压合并体位性低血压发生靶器官损害的危险较高,130~139/70~79 mm Hg可能是老年高血压合并体位性低血压患者最佳的血压范围。     

老人血压切莫“重高轻低”

正很多老年人在测量血压时,都会谈野高冶色变,在低血压面前却不以为然,甚至感到庆幸,认为这是健康的标志。殊不知,野低血压冶不但在悄悄地向老年人的健康发起野进攻冶,并且可能造成很大的危害。血压"重高轻低",当心追悔莫及前不久,家住浦东的李大妈在半     

服用五类药要防低血压

王大爷是高血压老患者,平时服药很规律,血压控制得也比较理想,但最近发现每天早上起床时会头晕,有时眼前发黑、站立不稳,甚至有一次摔倒在床上。王大爷以为是血压又高了,但一测量血压不高,他百思不得其解,就赶紧来医院咨询。药师经过仔细询问,找到了王大爷头晕的原因:低血压。     

新疆部分部队女军人低血压患病情况及体型状况调查

目的了解新疆部队女军人低血压患病情况及体型状况,为保障女军人身体健康提供参考依据。方法对新疆部分部队1610名女军人进行低血压普查,测量其身高和体质量,计算体质指数(BMI)和体型状况指标,比较低血压女军人与血压正常女军人BMI和体型状况达标率。结果本组1610名女军人中,患低血压152例,患病率9.4%;低血压女军人平均BMI为(20.4±1.6),明显低于血压正常女军人(22.1±2.6,P0.01);低血压女军人体型达标率(62.5%)明显低于血压正常女军人(96.7%,P0.01)。结论新疆部分部队女军人低血压患病率较高,体质普遍瘦弱,体型状况达标率较低,影响部队战斗力,应加以干预。     

抗精神病药物引起体位性低血压的影响及护理

目的：研究抗精神病药物对血压的影响及护理。方法：随机选择新入院首次服药患者、首次服药后第一次加药及长期住院精神病患者各40例，通过测量卧位与立位时上肢血压进行分析，同时并进行相应护理。结果：首次服药患者体位性低血压发生率26.7%，第一次加药后患者体位性低血压发生率为13.3%，长期服药患者体位性低血压发生率为16.7%。结论：新入院首次服药患者较易发生体位性低血压，应加强观察及护理，防止或减少体位性低血压的发生。     

瘦高女子缘何多血压低

某市体委最近对全体运动员进行了一次体检,结果发现一些体型瘦长苗条的女运动员在测量血压时,均表现为血压低。这些年轻的运动员着急了,因为健康的身体对她们来说尤为重要,于是她们纷纷来到医务所找医生询问究竟。 医生告诉姑娘们,所谓低血压,是指动脉血压的收缩压(俗称高压)低于12千帕(90毫米汞柱)、舒张压(俗称低压)低于8千帕(60毫米汞柱)。医学上将低血压分为两大类,即:生理性低血压和病理性低血压。     

动态血压监测与高血压相关疾病研究进展

动态血压监测(ambulatory blood pressure vnonitoring,ABPM)是应用动态血压记录仪测量患者24 h内每间隔一定时间的血压值的方法。能够监测白天、夜间以及24 h血压变化、昼夜节律等信息,除用于高血压、低血压的诊断外,还用于指导降压治疗、评价药物疗效,同时在高血压相关疾病的监测中,对高血压靶器官功能损害及心脑血管事件进行预测。本文就ABPM与高血压相关疾病监测方面的研究进展进行综述,旨在为同道提供参考。     

无创血压测量技术的改进与进展

介绍数种常规的无创血压测量方法-柯氏音法、示波法和双袖带法及其改进。重点对国际上连续无创血压测量的新型实用技术、方法及前景进行较为详细的介绍,如动脉张力测量法、动脉容积钳制法、脉搏波速度测量法、超声测压法以及小波分析和模糊识别技术在血压信号处理中的应用等。指出无创血压测量技术,尤其是无创连续血压测量方法有着巨大的市场需求;脉搏波速度测量法能实现真正意义上的连续无创血压测量,因此具有广泛的应用前景,而采用新理论进行连续的无创血压测量将是该领域的目标和发展方向。     

老年性体位性低血压合并卧位高血压10例诊治分析

目的探讨老年性体位性低血压合并卧位高血压的早期诊断及治疗。方法对10例老年性体位性低血压合并卧位高血压患者的临床资料回顾性分析。结果10例早期均误诊。结论对于老年性体位性低血压合并卧位高血压的患者,早期测卧立位血压,早期诊断。治疗时不应单纯追求降压,也应兼顾低血压所致的器官灌注不足及高血压所致的靶器官损害,降压应缓慢,维持血压稳定性更重要。     

双袖带血压测量技术

本研究采用“双方程技术”，提出一种新的血压测量方法——双袖带血压测量法。结合双袖带波形判定出收缩压和舒张压是基于每个被测个体的特性，而非大量样本的统计结果，与波动法自动血压计相比，其测量准确性大大提高。本文还阐述了目前末见相关报道的有关双袖带波形的新特征。     

基于个体特征的无创血压监测仪的研制

传统的波动法血压无创测量技术由于利用了统计学原理，因此必然造成测量时的个体误差。本文介绍了一种基于个体特征的利用波动法的血压无创监测技术，该技术能有效避免传统波动法的缺点。实际实验表明，该技术对不同人体和不同的人体血压状态都能进行准确测量，对危重病人和全麻病人的监护具有很大的应用价值。     

Orthostatic Hypotension and Falls in Older Adults: A Systematic Review and Meta-analysis

ObjectivesOrthostatic hypotension is a potential risk factor for falls in older adults, but existing evidence on this relationship is inconclusive. This study addresses the association between orthostatic hypotension and falls.DesignSystematic review and meta-analysis of the cross-sectional and longitudinal studies assessing the association between orthostatic hypotension and falls, as preregistered in the PROSPERO database (CRD42017060134).Setting and participantsA literature search was performed on February 20, 2017, in MEDLINE (from 1946), PubMed (from 1966), and EMBASE (from 1947) using the terms orthostatic hypotension, postural hypotension, and falls. References of included studies were screened for other eligible studies. Study selection was performed independently by 2 reviewers using the following inclusion criteria: published in English; mean/median age of the population ≥65 years; blood pressure measurement before and after postural change; and assessment of the association of orthostatic hypotension with falls. The following studies were excluded: conference abstracts, case reports, reviews, and editorials. Data extraction was performed independently by 2 reviewers.MeasuresUnadjusted odds ratios of the association between orthostatic hypotension and falls were used for pooling using a random effects model. Studies were rated as high, moderate, or low quality using the Newcastle-Ottawa Scale.ResultsOut of 5646 studies, 63 studies (51,800 individuals) were included in the systematic review and 50 studies (49,164 individuals) in the meta-analysis. Out of 63 studies, 39 were cross-sectional and 24 were longitudinal. Orthostatic hypotension was positively associated with falls (odds ratio 1.73, 95% confidence interval 1.50-1.99). The result was independent of study population, study design, study quality, orthostatic hypotension definition, and blood pressure measurement method.Conclusions and implicationsOrthostatic hypotension is significantly positively associated with falls in older adults, underpinning the clinical relevance to test for an orthostatic blood pressure drop and highlighting the need to investigate orthostatic hypotension treatment to potentially reduce falls.     

A spiroarteriocardiorhythmograph

The design and principle of operation of a spiroarteriocardiorhythmograph are described. The device provides continuous noninvasive measurement of arterial pressure, detection of inhaled and exhaled air flows with a high-sensitivity ultrasonic spirometr, electrocardiogram detection, and joint analysis of these dynamal processes. Continuous measurement of pressure is performed by the method suggested by Penaz. The method is based on assessment of the volume of blood vessels of patient's finger from photoplethysographic signal. An electropneumatic follow-up system produces essure counteracting the changes in the diameter of arterial vessels patient's finger under the cuff. Thus, the diameter of the finger arteries remains constant, and the pressure in the cuff is equal to blood pressure in the arteries. This provides a unique opportunity for long-term detection of the entire curve of arterial pressure. Previously, such measurements could be performed only by the invasive Oxford technique.     

Methods for increasing the reliability and noise protection of arterial pressure measurement channel

Noninvasive measurement of arterial blood pressure is an important function of modem monitoring systems. Presently, most arterial pressure measurement channels implement oscillometric method. This method is based on detection of small-amplitude pulsation of limb volume below occlusion cuff during compression/decompression. The main goal of the upgrade to the oscillometric method is to increase the accuracy, reliability, and noise protection of detection of arterial pressure parameters. This work describes a possible approach to improvement of reliability of the oscillographic method based on synchronous detection of several signals (e.g., volume signal, tachosignal and its derivatives with simultaneous correction of signal processing data on the bases of a priori information about signal, and processing adaptation of data processing algorithm to given signal realization).     

对双袖带血压测量技术的改进

双袖带波形血压测量法判定血压是基于每个被测个体动脉波动波形，与常规无创自动血压计相比，其位于收缩压和舒张压处的特征更明显，测量准确性提高。本研究对这种血压测量方法进一步加以改进，使其在保持准确性的同时降低测量的复杂度，方便日常测量。     

基于振动法和柯氏音法的无创血压测量值差异性研究

对无创血压测量仪测量值误差异性展开分析。用与各种血压测量技术进行比较的方法，着重分析了振动法无创血压测量和柯氏音听诊法。使用振动法无创伤血压测量监护仪和柯氏音听诊法对样本人群进行了血压测量，分析所得数据，结果表明，基于振动法和柯氏音法无创血压测量仪测量值差异小，准确性也比较好。同时，也展望了无创血压装置未来的发展方向。     

无创连续血压测量方法的研究进展

本文概述了目前国内外无创连续血压测量方法的研究进展，重点介绍了动脉张力测定法、容积补偿法、脉搏波速测定法和利用脉搏波特征参数进行血压测量方法的原理和特点，并对今后无创连续血压测量的发展趋势作出了展望。