What are the clinical manifestations of hypotension in the elderly

The systolic blood pressure of the elderly is lower than 13.3kpa, and the diastolic blood pressure is lower than 8kpa, which is called hypotension in the elderly. Elderly hypotension is often divided into primary, secondary and orthostatic hypotension. There are many reasons for hypotension in the elderly, the most common being physical weakness after illness, heart disease, chronic lung disease, malnutrition caused by long-term bed rest, and usual thin constitution, family inheritance, etc.

Clinical manifestations of hypotension in the elderly

(1) Asymptomatic hypotension is almost always discovered occasionally during physical examination or outpatient or hospitalization due to other diseases. The elderly have a better tolerance to hypotension, coupled with factors such as unresponsiveness and cover-up of other diseases, hypotension is easily overlooked. In fact, after detailed medical history inquiry, there are very few absolutely asymptomatic patients. Patients often have mild fatigue, occasional dizziness, dizziness and so on. Generally no organic disease. Its blood pressure is low and pulse pressure is small, heart rate is slow, introverted, not easy to be excited, it can be seen in obese and emaciated people, and it is more common in thin and thin people, the elderly are more common than the young, and women are more common than men.

(2) Symptomatic hypotension mostly has mild or moderate brain and other organ ischemia symptoms, such as weakness, dizziness, headache, insomnia, poor memory, difficulty concentrating, etc. Some patients who originally suffered from hypertension have long-term low blood pressure after a large area and severe myocardial infarction. At this time, in addition to hypotension, there is evidence of myocardial ischemia.

(3) When symptomatic hypotension is severe, there may be sudden and short-term loss of consciousness accompanied by the disappearance of postural tension, that is, the occurrence of syncope.

Prodromal symptoms of syncope are:

①. Dizziness and dizziness after excessive physical or mental work, often aggravated by changing body positions.

② Blurred vision, vertigo, amaurosis, etc. appear soon after dizziness.

③. May have mild hearing loss or tinnitus.

④ Weakness, unsteady standing, feeling of wanting to overwhelm.

⑤. Pale complexion, nervousness, difficulty in speaking, and even unable to open mouth when wanting to speak.

⑥, may be accompanied by nausea, vomiting and other gastrointestinal symptoms.

⑦. Most patients have no time to support the support or take the lying or sitting position immediately and faint and fall down.

A considerable number of patients faint when no one else is present. Some patients may have facial or head skin abrasions, the elderly may fracture due to a fall, and may also be combined with cerebrovascular accident or acute myocardial infarction due to a sudden and significant drop in blood pressure. Combined with pneumonia. Except for cardiogenic and neurogenic (central) ones, there is no obvious change in breathing, the heart rate can be slow or fast, the heart sound is low or weak; both deep and shallow nerve reflexes exist (different from coma). Most patients can clearly describe the situation or the environment before syncope. Generally, the attack lasts for more than ten seconds to ten minutes, and rarely exceeds 20 minutes. After the patient woke up, he still had pale complexion, sweating, cold hands and feet, and inability to speak. A small number of people who have not been in syncope for a long time and have no serious trauma or complications can go to the nearby medical unit for treatment automatically or with the support of others. At this time, most of them have no obvious abnormalities; Corresponding positive signs can be checked.