Analysis Of The Incidence And Risk Factors In Elderly Chronic Heart Failure Patients With Orthostatic Hypotension

Objective:The purpose of this study is to analysis the incidence and risk factors in elderly chronic heart failure patients with orthostatic hypotension,so as to help the clinical doctors to better understand the diseaseand make corresponding prevention and treatment to improve the prognosis of the patients.Methods: During the period from January 2017 to December 2017,we collected in total of 257 chronic heart failure patients over 65 years old in the Department of Cardiology and inpatient department of the General Hospital of Xinjiang Military Region as the research object.To fill in their basic information,accordance with whether or not they have orthostatic hypotension,it can be divided into two groups,one group is simple heart failure,the number of them is 184 cases;The other group is patients with heart failure combined with orthostatic hypotension,the number of the people is 73 cases.Then take a regular physical examination of their body(including measurement of their height and weight and orthostatic hypotension screening)and related blood sampling tests(including blood sugar,blood lipid,urea nitrogen,blood creatinine,uric acid).Last our doctors will record all the datas and make statistical analysis.Results:1.The incidence of elder chronic heart failure combined with orthostatic hypotension was28.4%(73 cases /257 cases),and there was no significant difference in gender between the two groups(P > 0.05).2.The proportion of 65~79 years old in the group of heart failure combined with orthostatic hypotension was 22.6%(26 cases /117 cases),The proportion of more than 80 years old in the group was 33.6%(47 cases /140 cases),there was a statistically significant in the difference between the two group(P < 0.05).The difference of blood pressure and heart rate between the two groups was statistically significant(P <0.05),but there was no statistically significant difference between the two groups(P >0.05).3.The incidence of orthostatic hypotension in patients with chronic heart failure in the group of heart function classification II,also called NYHA grade II,was 18.8%;NYHA grade III was 27.2%;and the patients in group of NYHA grade IV was 37.6%.The incidence of orthostatic hypotension increased with the increase of the classification of heart function,and there was a statistically significant difference between the three groups(P < 0.05).4.In chronic heart failure patients with orthostatic hypotension group and simple heart failure group were between two groups were compared after the standard of P< 0.05,the difference was statistically significant variables in multivariate Logistic regression analysis.It shows that there is a correlation between decubitus systolic blood pressure,standing 0 min systolic blood pressure,decubitus heart rate,standing 2 min heart rate,hypertension,diabetes,stroke and heart failure combined with orthostatic hypotension,they are the risk factors for heart failure with orthostatic hypotension(P <0.05).Conclusion:The incidence of orthostatic hypotension in patients with chronic heart failure is 28.4%.For those with a typical symptoms of erect hypotension,it is possible to monitor the blood pressure and heart rate in the supine position so as to find the disease early and take preventive measures.The incidence of erect hypotension increased with age and severity of heart failure,and the incidence of erect hypotension increased in patients with hypertension,diabetes,and stroke,so the above disease was considered as a risk factor for chronic heart failure and orthostatic hypotension.