Orthostatic hypotension in older patients

Author: Mader, Scott L

Source: Aging Health, Volume 2, Number 3, June 2006 , pp. 505-513(9)

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Abstract:

Orthostatic hypotension is defined as a drop in systolic blood pressure of at least 20 mmHg or of diastolic blood pressure of at least 10 mmHg within 3 min of standing. It occurs in 30-50% of elderly individuals with disease and/or medication risk factors. It is uncommon in healthy elderly people. Most patients with orthostatic blood pressure changes do not have typical symptoms and therefore symptoms are not helpful in deciding who should be screened. Epidemiological data suggest that the presence of orthostatic hypotension is associated with syncope, falls, stroke and death. The treatment approach is not standardized, but a stepped-care algorithm is presented in this article, which is likely to be successful in many patients. Future studies need to focus on the potential benefits of screening and treating patients with this disorder, especially if they are asymptomatic.

Keywords: aging; fludrocortisone; hypotension; licorice; midodrine; orthostatic

Document Type: Research article

DOI: http://dx.doi.org/10.2217/1745509X.2.3.505

Affiliations: 1: Rehabilitation & LTC Division, Portland VA Medical Center, Portland, OR 97239, USA

Publication date: 2006-06-01

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Aging Health leading coverage of current and emerging topics relating to the safe and effective management of therapy in the elderly, all subject to rigorous peer review. The journal focuses on the most important advances and highlights their relevance in the clinical setting. The journal has been designed to deliver essential concise information in an easily assimilable format - vital for the increasingly time-constrained professional.
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