Document Detail


Orthostatic hypotension.
MedLine Citation:
PMID:  12180246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A common problem among elderly people, orthostatic hypotension is associated with significant morbidity and mortality, which may be caused by medications, the cumulative effects of age- and hypertension-related alterations in blood pressure regulation, or age-associated diseases that impair autonomic function. Evaluation requires multiple blood pressure measurements taken at different times of the day and after meals or medications. Central and peripheral nervous system disorders should be sought, and the laboratory evaluation should concentrate on ruling out diabetes mellitus, amyloidosis, occult malignancy, and vitamin deficiencies. If orthostatic hypotension is detected, it should be considered a risk factor for adverse outcomes and treated first with nonpharmacologic interventions, including the withdrawal of potentially hypotensive medications. In patients with hypertension and orthostatic hypotension, the judicious treatment of hypertension may be helpful. For persistent, symptomatic orthostatic hypotension caused by autonomic failure, pharmacologic interventions include fludrocortisone, midodrine, and a variety of other agents. The careful evaluation and management of orthostatic hypotension will hopefully result in a significant reduction in falls, syncope, and fractures, and an attenuation of functional decline in elderly patients.
Authors:
Seiji Mukai; Lewis A Lipsitz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Clinics in geriatric medicine     Volume:  18     ISSN:  0749-0690     ISO Abbreviation:  Clin. Geriatr. Med.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-08-15     Completed Date:  2002-12-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8603766     Medline TA:  Clin Geriatr Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  253-68     Citation Subset:  IM    
Affiliation:
Hebrew Rehabilitation Center for Aged, Research and Training Institute, Beth Israel Deaconess Medical Center, Department of Medicine, Division on Aging, Harvard Medical School, Boston, MA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Pressure
Frail Elderly
Humans
Hypotension, Orthostatic* / complications,  physiopathology,  therapy
Middle Aged
Risk Factors
Syncope / etiology
Grant Support
ID/Acronym/Agency:
AG04390/AG/NIA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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