arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2023-29-3-253-265arthyper-2317Research ArticleСтатьиArticlesОртостатическая гипотензия и ее ассоциации с гериатрическими синдромами у лиц старше 65 лет: данные исследования ЭВКАЛИПТOrthostatic hypotension and its associations with geriatric syndromes in subjects over 65 years old: data from EVKALIPT studyhttps://orcid.org/0000-0002-6021-7864ВоробьёваН. М.VorobyevaN. M.

Воробьева Наталья Михайловна - доктор медицинских наук, старший научный сотрудник лаборатории клинической фармакологии и фармакотерапии

ул. 1-я Леонова, д. 16, Москва, 129226

Тел.: +7 (499) 187–64–67

Natalya M. Vorobyeva, MD, PhD, DSc, Senior Researcher, Laboratory of Clinical Pharmacology and Pharmacotherapy

16 1st Leonova str., Moscow, 129226

Phone: +7 (499) 187–64–67

vorobyeva_nm@rgnkc.ruhttps://orcid.org/0000-0002-1695-9107ЛузинаА. В.LuzinaA. V.

Лузина Александра Вячеславовна - кандидат медицинских наук, научный сотрудник лаборатории сердечно-сосудистого старения

ул. 1-я Леонова, д. 16, Москва, 129226

Тел.: +7 (499) 187–64–67

Aleksandra V. Luzina, MD, PhD, Researcher, Laboratory of Cardiovascular Aging

16 1st Leonova str., Moscow, 129226

Phone: +7 (499) 187–64–67

alexalav@mail.ruhttps://orcid.org/0000-0001-5964-5725МалаяИ. П.MalayaI. P.

Малая Ирина Павловна - кандидат медицинских наук, заведующая лабораторией клинической фармакологии и фармакотерапии

ул. 1-я Леонова, д. 16, Москва, 129226

Тел.: +7 (499) 187–64–67

Irina P. Malaya, MD, PhD, Head, Laboratory of Clinical Pharmacology and Pharmacotherapy

16 1st Leonova str., Moscow, 129226

Phone: +7 (499) 187–64–67

malaya_ip@rgnkc.ruhttps://orcid.org/0000-0002-1628-5093КотовскаяЮ. В.KotovskayaYu. V.

Котовская Юлия Викторовна - доктор медицинских наук, профессор, заместитель директора по научной работе

ул. 1-я Леонова, д. 16, Москва, 129226

Тел.: +7 (499) 187–64–67

Yuliya V. Kotovskaya, MD, PhD, DSc, Professor, Deputy Director

16 1st Leonova str., Moscow, 129226

Phone: +7 (499) 187–64–67

kotovskaya@bk.ruhttps://orcid.org/0000-0002-4193-688XТкачёваО. Н.TkachevaO. N.

Ткачева Ольга Николаевна - доктор медицинских наук, профессор, член-корреспондент РАН, директор

ул. 1-я Леонова, д. 16, Москва, 129226

Тел.: +7 (499) 187–64–67

Olga N. Tkacheva, MD, PhD, DSc, Professor, Corresponding Member of the Russian Academy of Sciences, Director

16 1st Leonova str., Moscow, 129226

Phone: +7 (499) 187–64–67

tkacheva@rgnkc.ruОбособленное структурное подразделение Российский геронтологический научно-клинический центр федерального государственного автономного образовательного учреждения высшего образования «Российский научно-исследовательский медицинский университет имени Н. И. Пирогова» Министерства здравоохранения Российской ФедерацииРоссияRussian Gerontology Research and Clinical Centre, Pirogov’s Russian National Research Medical UniversityRussian Federation202305042023293253265Copyright © Воробьёва Н.М., Лузина А.В., Малая И.П., Котовская Ю.В., Ткачёва О.Н., 20232023Воробьёва Н.М., Лузина А.В., Малая И.П., Котовская Ю.В., Ткачёва О.Н.Vorobyeva N.M., Luzina A.V., Malaya I.P., Kotovskaya Y.V., Tkacheva O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2317

Цель исследования - оценить распространенность ортостатической гипотензии (ОГ) и проанализировать ее ассоциации с гериатрическими синдромами (ГС) у лиц в возрасте ≥ 65 лет.Материалы и методы. Обследовано 4308 человек (30 % мужчин) в возрасте от 65 до 107 лет (средний возраст 78 ± 8 лет), проживающих в 11 регионах РФ, которых распределили на 3 возрастные группы (65–74 года, 75–84 года и ≥ 85 лет). Всем участникам выполнена комплексная гериатрическая оценка, которая состояла из двух этапов: 1) анкетирование по специально разработанному опроснику; 2) объективное обследование. Ортостатическая проба выполнена у 3982 (92,4 %) пациентов. ОГ диагностировали при снижении систолического артериального давления (АД) на ≥ 20 мм рт. ст. или диастолического АД — на ≥ 10 мм рт. ст. (или при снижении обоих параметров) в течение 3 минут после перехода в ортостаз.Результаты. Частота ОГ у всех обследуемых составила 7,9 %, в том числе 6,7 % — у лиц в возрасте 65–74 лет, 8,4 % — в возрасте 75–84 лет, 8,8 % — в возрасте ≥ 85 лет (р для тренда = 0,093). Однофакторный регрессионный анализ показал, что с повышением возраста на каждый 1 год шансы иметь ОГ увеличиваются на 1,4 % (отношение шансов [ОШ] 1,014; 95-процентный доверительный интервал [95 % ДИ] 1,001–1,028; р = 0,042). Однофакторный регрессионный анализ также продемонстрировал, что с наличием ОГ были ассоциированы 5 из 15 изученных ГС: недержание мочи (ОШ 1,41; 95 % ДИ 1,1–1,77; р = 0,004) и кала (ОШ 1,61; 95 % ДИ 1,01–2,58; р = 0,046), мальнутриция (ОШ 1,77; 95 % ДИ 1,15–2,72; р = 0,009), дефицит зрения (ОШ 2,23; 95 % ДИ 1,47–3,40; р < 0,001) и падения за предшествующий год (ОШ 1,37; 95 % ДИ 1,08–1,75; р = 0,010). Многофакторный регрессионный анализ с поправкой на возраст и пол установил, что только 2 ГС независимо ассоциированы с наличием ОГ: недержание мочи (ОШ 1,36; 95 % ДИ 1,08–1,72; р = 0,009) и дефицит зрения (ОШ 2,01; 95 % ДИ 1,37–3,19; р = 0,001).Заключение. В исследовании ЭВКАЛИПТ впервые получены отечественные данные о распространенности ОГ у лиц в возрасте ≥ 65 лет и изучены ассоциации между ОГ и ГС.

Objective. To estimate the prevalence of orthostatic hypotension (OH) and analyze its associations with geriatric syndromes (GS) in subjects aged ≥ 65 years.Design and methods. In total, 4308 subjects (30 % males) aged 65 to 107 years (mean age 78 ± 8 years) living in 11 regions of the Russian Federation were examined, who were divided into 3 age subgroups (65–74 years, 75–84 years and ≥ 85 years). All participants underwent a comprehensive geriatric assessment, which consisted of two stages: 1) questionnaire on a specially developed questionnaire; 2) objective examination. Orthostatic test was performed in 3982 (92,4 %) patients. OH was diagnosed with a decrease in systolic blood pressure (BP) by ≥ 20 mm Hg or diastolic BP — by ≥ 10 mm Hg (or a decrease in both parameters) within 3 minutes after switching to orthostasis.Results. The frequency of OH in all subjects was 7,9 %, including 6,7 % in subjects aged 65–74 years, 8,4 % — 75–84 years, 8,8 % — ≥ 85 years (p for trend = 0,093). Univariate regression analysis showed that with an age increase per every 1 year, the odds of OH increased by 1,4 % (odds ratio [OR] 1,014; 95 % confidence interval [CI] 1,001–1,028; p = 0,042). Univariate regression analysis also demonstrated that 5 of the 15 studied GSs were associated with the presence of OH: urinary (OR 1,41; 95 % CI 1,12–1,77; p = 0,004) and fecal (OR 1,61; 95 % CI 1,01–2,58; p = 0,046) incontinence, malnutrition (OR 1,77; 95 % CI 1,15–2,72; p = 0,009), visual deficit (OR 2,23; 95 % CI 1,47–3,40; p < 0,001) and falls in the previous year (OR 1,37; 95 % CI 1,08–1,75; p = 0,010). Multivariate regression analysis adjusted for age and sex found that only 2 GSs were independently associated with the presence of OH: urinary incontinence (OR 1,36; 95 % CI 1,08–1,72; p = 0,009) and visual deficit (OR 2,01; 95 % CI 1,37–3,19; p = 0,001).Conclusions. The EVKALIPT study first obtained domestic data on the prevalence of OH in subjects aged ≥ 65 years and studied the associations between OH and GSs.

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The authors declare that there are no conflicts of interest present.