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Title 低血圧 (起立性低血圧)
Subtitle 特集 高血圧診療update - 診断・治療の最新動向 - V. 特論
Authors 戸伏倫之1, 安藤眞一2
Authors (kana)
Organization 1福岡県済生会二日市病院 循環器内科, 2九州大学病院 睡眠時無呼吸センター
Journal 日本臨牀
Volume 78
Number 2
Page 335-341
Year/Month 2020 / 2
Article 報告
Publisher 日本臨牀社
Abstract 「はじめに」 広く低血圧の定義として使用されている値は「収縮期血圧が男性で110mmHg以下, 女性で収縮期血圧100mmHg以下かつ/あるいは両性ともに拡張期血圧60mmHg以下」である. もともとWHOより収縮期血圧での基準値が示され, その後, 拡張期血圧に関する基準が追加されている. そのため低血圧の定義で拡張期血圧の定義に関してはスタディごとに異なり, 収縮期血圧基準かつ拡張期血圧基準で診断しているものと, 収縮期血圧のみで診断するものが見られる. 拡張期血圧単独では低血圧と診断できないと考えられる. また, 日内リズムで血圧は変動するため, 朝昼夕の順番をランダムに数回/日測定し, 収縮期血圧および拡張期血圧の平均値を取ることもある. 血圧測定に際してはアルコール, タバコ, カフェイン入り飲料を数時間前から禁止し, 15分ほどの安静時間をおいた後に測定する. スクリーニングでは収縮期血圧の基準で, 低血圧と診断される者は男性の1.6〜2.7%, 女性の0.3〜3.6%, 拡張期血圧の基準では女性の1.2〜2.7%, 男性の1.0〜1.1%に相当するとされる.
Practice 医学総合
Keywords hypotension, orthostatic hypotension, non-pharmacological treatment
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