体位性低血压是老年人常见的一种临床疾病,起病隐袭,常常不被重视.体位性低血压根据病因不同可分为急性和慢性,急性体位性低血压通常继发于药物、体液丢失或肾上腺机能不全,慢性体位性低血压常常是由于血压调节机制异常和自主神经功能紊乱所致.体位性低血压的诊断需要一个综合的病史评价,包括自主神经系统功能紊乱的症状、规范的血压测量以及实验室检查结果,强调首次发现的体位性低血压,并除外神经退行性疾病、淀粉样变性、糖尿病、贫血和维生素缺乏等病因.长期的血压随体位变化降低,会导致心、脑血管所供应组织器官灌注不足,增加缺血性心脑血管疾病的发病率.体位性低血压的治疗目标是改善患者症状,尽可能不影响患者的日常生活,并使患者血压控制在一个合理的目标范围内,包括药物治疗与非药物治疗.临床医师应高度重视这类人群,合理评估与管理,从而尽量减少老年人跌倒、骨折、心肌缺血等不良事件的发生.“,”Orthostatic hypotension is a common problem among elderly patients.While acute orthostatic hypotension is usually secondary to medication,adrenal insufficiency,fluid or bloodloss,chronic orthostatic hypotension is a frequent occurrence due to altered blood pressure regulatory mechanisms and autonomic dysfunction.The diagnostic evaluation requires a comprehensive history including symptoms of autonomic nervous system dysfunction,comprehensive blood pressure measurement,and laboratory studies.Laboratory investigation and imaging studies should be based upon initial findings with an emphasis on excluding diagnoses of neurodegenerative diseases,amyloidosis,diabetes,anemia,and vitamin deficiency as the cause.A change in orthostatic blood pressure will lead to tissue and organ are hypoperfusion,which increases the incidence of the ischemic cardiovascular and cerebrovascular diseases.The goals of treatment are to improve symptoms and make the patient as ambulatory as possible rather than trying to achieve arbitrary blood pressure goals,including pharmacological and nonpharmacological interventions.With proper evaluation and management,the occurrence of adverse events,including falls,fracture,functional decline,and myocardial ischemia,can be significantly reduced.