2023.08.07 기립성 저혈압(Orthostatic hypotension)

안녕하세요,

국진 지킴이입니다. 

오늘은 기립성 저혈압에 대해서 알아보도록 하겠습니다. 

기립성 저혈압이란? 

영어로 orthostatic hypotension 이라고 합니다. 

또 다른 말로는 postural hypotension 이라고 합니다.

 

Overview

 

기립성 저혈압(기립성 저혈압이라고도 함)은 앉거나 누운 후 서 있을 때 발생하는 저혈압의 한 형태입니다. 기립성 저혈압은 어지러움이나 현기증, 실신을 유발할 수 있습니다.

 

Orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when standing after sitting or lying down. Orthostatic hypotension can cause dizziness or lightheadedness and possibly fainting.

 

 

기립성 저혈압은 경미할 수 있습니다. 에피소드가 짧을 수 있습니다. 그러나 오래 지속되는 기립성 저혈압은 더 심각한 문제를 나타낼 수 있습니다. 일어설 때 자주 현기증이 난다면 의료 서비스 제공자를 만나는 것이 중요합니다. 간헐적인 기립성 저혈압은 일반적으로 탈수나 장기간의 침상 안정과 같은 분명한 원인으로 인해 발생합니다. 상태는 쉽게 치료됩니다. 만성 기립성 저혈압은 일반적으로 다른 건강 문제의 징후이므로 치료는 원인에 따라 다릅니다.

 

Orthostatic hypotension can be mild. Episodes might be brief. However, long-lasting orthostatic hypotension can signal more-serious problems. It's important to see a health care provider if you frequently feel lightheaded when standing up.

Occasional orthostatic hypotension is usually caused by something obvious, such as dehydration or lengthy bed rest. The condition is easily treated. Chronic orthostatic hypotension is usually a sign of another health problem, so treatment depends on the cause.

 

증상

 

기립성 저혈압의 가장 흔한 증상은 머리가 어지러워지거나 앉거나 누웠다가 일어설 때의 현기증입니다. 증상은 일반적으로 몇 분 이내로 지속됩니다.

기립성 저혈압 징후 및 증상은 다음과 같습니다.

기립 시 현기증 또는 현기증
흐릿한 시야
약함 
기절(실신)
착란

Symptoms

The most common symptom of orthostatic hypotension is lightheadedness or dizziness when standing after sitting or lying down. Symptoms usually last less than a few minutes.

Orthostatic hypotension signs and symptoms include:

• Lightheadedness or dizziness upon standing
• Blurry vision
• Weakness
• Fainting (syncope)
• Confusion

 

Causes

When standing from a sitting or lying position, gravity causes blood to collect in the legs and belly. Blood pressure drops because there's less blood flowing back to the heart.

Usually, special cells (baroreceptors) near the heart and neck arteries sense this lower blood pressure. The baroreceptors send signals to the brain. This tells the heart to beat faster and pump more blood, which evens out blood pressure. These cells also narrow the blood vessels and increase blood pressure.

Orthostatic hypotension occurs when something interrupts the body's process of dealing with the low blood pressure. Many conditions can cause orthostatic hypotension, including:

 

원인

 

앉거나 누운 자세에서 서 있을 때 중력으로 인해 다리와 배에 혈액이 모입니다. 심장으로 돌아가는 혈액이 줄어들기 때문에 혈압이 떨어집니다.

일반적으로 심장 및 목 동맥 근처의 특수 세포(압력수용기)는 이 낮은 혈압을 감지합니다. 압수용체는 뇌에 신호를 보냅니다. 이것은 심장이 더 빨리 뛰고 더 많은 혈액을 펌프하도록 지시하여 혈압을 고르게 합니다. 이 세포는 또한 혈관을 좁히고 혈압을 높입니다.

기립성 저혈압은 무언가가 저혈압을 처리하는 신체의 과정을 방해할 때 발생합니다. 다음과 같은 많은 조건이 기립성 저혈압을 유발할 수 있습니다.

 

국문	영문	국문	영문
탈수	Dehydration.	발열, 구토, 충분한 수분 섭취 부족, 심한 설사, 땀을 많이 흘리는 격렬한 운동 등은 모두 탈수증을 유발할 수 있습니다. 탈수는 혈액량을 감소시킵니다. 가벼운 탈수는 쇠약, 현기증, 피로와 같은 기립성 저혈압의 증상을 유발할 수 있습니다.	Fever, vomiting, not drinking enough fluids, severe diarrhea and strenuous exercise with a lot of sweating can all lead to dehydration. Dehydration decreases blood volume. Mild dehydration can cause symptoms of orthostatic hypotension, such as weakness, dizziness and fatigue.
심장 질환	Heart problems.	저혈압으로 이어질 수 있는 일부 심장 상태에는 극도로 낮은 심박수(서맥), 심장 판막 문제, 심장마비 및 심부전이 포함됩니다. 이러한 상태는 일어설 때 신체가 더 많은 혈액을 빠르게 펌핑하는 것을 방지합니다.	Some heart conditions that can lead to low blood pressure include extremely low heart rate (bradycardia), heart valve problems, heart attack and heart failure. These conditions prevent the body from quickly pumping more blood when standing up.
내분비 문제	Endocrine problems.	갑상선 상태, 부신 기능 부전(애디슨병) 및 저혈당(저혈당증)은 기립성 저혈압을 유발할 수 있습니다. 혈압을 조절하는 신호를 보내는 데 도움이 되는 신경을 손상시킬 수 있는 당뇨병도 마찬가지입니다.	Thyroid conditions, adrenal insufficiency (Addison's disease) and low blood sugar (hypoglycemia) can cause orthostatic hypotension. So can diabetes, which can damage the nerves that help send signals that control blood pressure.
신경계 장애.	Nervous system disorders.	파킨슨병, 다계통 위축, 레비 소체 치매, 순수 자율신경 부전 및 아밀로이드증과 같은 일부 신경계 장애는 혈압을 조절하는 신체의 능력을 방해할 수 있습니다.	Some nervous system disorders, such as Parkinson's disease, multiple system atrophy, Lewy body dementia, pure autonomic failure and amyloidosis, can disrupt the body's ability to control blood pressure.
식사.	Eating meals.	어떤 사람들은 식후 저혈압(식후 저혈압)을 경험합니다. 이 상태는 노인에게 더 흔합니다.	Some people have low blood pressure after eating meals (postprandial hypotension). This condition is more common in older adults.

 

이번에는 위험요소에 대해서 알아보도록 하겠습니다. 

 

Risk factors

The risk factors for orthostatic hypotension include:

• Age. Orthostatic hypotension is common in those who are age 65 and older. Special cells (baroreceptors) near the heart and neck arteries that control blood pressure can slow as you age. It also can be harder for an aging heart to speed up to make up for drops in blood pressure.
• Medications. These include medications used to treat high blood pressure or heart disease, such as diuretics, alpha blockers, beta blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors and nitrates.
• Other medications that can increase the risk of orthostatic hypotension include medications used to treat Parkinson's disease, certain antidepressants, certain antipsychotics, muscle relaxants, medications to treat erectile dysfunction and narcotics.
• Certain diseases. Diseases that can increase the risk of low blood pressure include some heart conditions, such as heart valve problems, heart attack and heart failure. They also include certain nervous system disorders, such as Parkinson's disease. And they include diseases that cause nerve damage (neuropathy), such as diabetes.
• Heat exposure. Being in a hot environment can cause heavy sweating and possibly dehydration, which can lower blood pressure and trigger orthostatic hypotension.
• Bed rest. Staying in bed for a long time because of an illness or injury can cause weakness. This can lead to orthostatic hypotension.
• Alcohol. Drinking alcohol can increase the risk of orthostatic hypotension.

국문	영문	설명
나이	Age.	Orthostatic hypotension is common in those who are age 65 and older. Special cells (baroreceptors) near the heart and neck arteries that control blood pressure can slow as you age. It also can be harder for an aging heart to speed up to make up for drops in blood pressure. 기립성 저혈압은 65세 이상에서 흔합니다. 혈압을 조절하는 심장 및 목 동맥 근처의 특수 세포(압력 수용체)는 나이가 들면서 느려질 수 있습니다. 또한 노화된 심장이 혈압 강하를 보충하기 위해 속도를 높이는 것이 더 어려울 수 있습니다.
약	Medications.	These include medications used to treat high blood pressure or heart disease, such as diuretics, alpha blockers, beta blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors and nitrates. Other medications that can increase the risk of orthostatic hypotension include medications used to treat Parkinson's disease, certain antidepressants, certain antipsychotics, muscle relaxants, medications to treat erectile dysfunction and narcotics. 여기에는 이뇨제, 알파 차단제, 베타 차단제, 칼슘 채널 차단제, 안지오텐신 전환 효소(ACE) 억제제 및 질산염과 같은 고혈압 또는 심장 질환 치료에 사용되는 약물이 포함됩니다. 기립성 저혈압의 위험을 증가시킬 수 있는 다른 약물에는 파킨슨병 치료에 사용되는 약물, 특정 항우울제, 특정 항정신병제, 근육 이완제, 발기 부전 치료 약물 및 마약이 포함됩니다.
일정 질병	Certain diseases.	Diseases that can increase the risk of low blood pressure include some heart conditions, such as heart valve problems, heart attack and heart failure. They also include certain nervous system disorders, such as Parkinson's disease. And they include diseases that cause nerve damage (neuropathy), such as diabetes. 저혈압의 위험을 증가시킬 수 있는 질병에는 심장 판막 문제, 심장 마비 및 심부전과 같은 일부 심장 상태가 포함됩니다. 여기에는 파킨슨병과 같은 특정 신경계 장애도 포함됩니다. 그리고 여기에는 당뇨병과 같은 신경 손상(신경병증)을 유발하는 질병이 포함됩니다.
열 노출	Heat exposure.	Being in a hot environment can cause heavy sweating and possibly dehydration, which can lower blood pressure and trigger orthostatic hypotension. 더운 환경에 있으면 심한 발한과 탈수를 유발할 수 있으며, 이는 혈압을 낮추고 기립성 저혈압을 유발할 수 있습니다.
침상 휴식	Bed rest.	Staying in bed for a long time because of an illness or injury can cause weakness. This can lead to orthostatic hypotension. 질병이나 부상으로 인해 오랫동안 침대에 누워 있으면 쇠약해질 수 있습니다. 이것은 기립성 저혈압으로 이어질 수 있습니다.
알코올	Alcohol.	Drinking alcohol can increase the risk of orthostatic hypotension. 음주는 기립성 저혈압의 위험을 증가시킬 수 있습니다.

 

 

Complications

Persistent orthostatic hypotension can cause serious complications, especially in older adults. These include:

• Falls. Falling as a result of fainting is a common complication in people with orthostatic hypotension.
• Stroke. The swings in blood pressure from standing and sitting as a result of orthostatic hypotension can be a risk factor for stroke due to the reduced blood supply to the brain.
• Cardiovascular diseases. Orthostatic hypotension can be a risk factor for cardiovascular diseases and complications, such as chest pain, heart failure or heart rhythm problems.

 

합병증 

 

지속적인 기립성 저혈압은 특히 노인에서 심각한 합병증을 유발할 수 있습니다. 여기에는 다음이 포함됩니다.

 

 

국문	원인	내용	영문
낙상	Falls.	실신으로 인한 낙상은 기립성 저혈압이 있는 사람들에게 흔한 합병증입니다.	Falling as a result of fainting is a common complication in people with orthostatic hypotension.
뇌졸중	Stroke.	기립성 저혈압의 결과로 서 있을 때와 앉을 때의 혈압 변동은 뇌로의 혈액 공급 감소로 인해 뇌졸중의 위험 요소가 될 수 있습니다.	The swings in blood pressure from standing and sitting as a result of orthostatic hypotension can be a risk factor for stroke due to the reduced blood supply to the brain.
심혈관계 질환	Cardiovascular diseases.	기립성 저혈압은 흉통, 심부전 또는 심장 리듬 문제와 같은 심혈관 질환 및 합병증의 위험 요소가 될 수 있습니다.	Orthostatic hypotension can be a risk factor for cardiovascular diseases and complications, such as chest pain, heart failure or heart rhythm problems.