[Orthostatic hypotension in elderly patients]

Abstract

- Orthostatic hypotension is a condition in which there is insufficient recovery of the blood pressure drop which occurs after getting up, which causes a temporary reduction of cerebral perfusion. This increases the risk of falls resulting in injuries.- Orthostatic hypotension is most common in the elderly. The cause is usually multifactorial (including reduced circulating volume, reduced peripheral resistance and limited heart rate increase). Orthostatic hypotension caused by autonomic dysfunction is called neurogenic orthostatic hypotension.- The most important groups of drugs that may elicit orthostatic hypotension are: diuretics (but only if they lead to hypovolaemia), antidepressants (mainly tricyclic antidepressants), sympatholytics (alpha-blockers as well as beta-blockers) and vasodilators (for example, nitrates).- Treatment of the elderly with orthostatic hypotension starts with lifestyle advice (getting up slowly) and possible medication adjustments.