Title: Prevalence of orthostatic hypotension and relationship with drug use amongst older patients
Authors: Pepersack, T ×
Gilles, C
Petrovic, M
Spinnewine, A #
Baeyens, H #
Beyer, I #
Boland, B #
Dalleur, O #
De Lepeleire, Jan #
Even-Adin, E #
Van Nes, MC #
Samalea-Suarez, A #
Somers, A #
Issue Date: 2013
Publisher: Acta clinica belgica
Series Title: Acta Clinica Belgica vol:68 issue:2 pages:107-112
Abstract: ABSTRACT
Introduction: Orthostatic hypotension (OH) is said to
be highly prevalent in older people. Drugs are often
involved as causative factor. Nevertheless, few data are
available about the prevalence of OH and its relationship
with drugs in olders.
Objectives: To review data about (i) the prevalence
and characteristics of OH in older patients; and (ii) the
relationship between OH and drugs.
Methods: Review of publications from Ovid (Pub-
Med) from 1980 to May 2011 using the following key
words: “orthostatic hypotension” combined with “elderly”
or equivalent for the analysis of prevalence (first search)
and “orthostatic hypotension” combined with “drugs” or
equivalent to assess the relationship between OH and
drugs (second search).
Results: Fifty-one publications (of which 14 with
original data) were retrieved from the prevalence search,
31 for the second search (8 with original data: 7 retrospective
studies and 1 prospective cohort study) and
12 reviews or experts opinions. Prevalence of OH varies
according to the characteristics of the subjects, the settings
of the studies, and the procedures of blood pressure
measurement. In acute geriatrics units, two studies
reported a prevalence of over 30% and one study mentioned
that 68% of the patients presented with at least
one episode during the day. OH was associated with several
geriatric problems: gait disorders, balance disorders,
falls, cerebral hypoperfusion, transient ischemic attacks,
cognitive impairment, acute myocardial infarct and systolic
hypertension. OH can also be asymptomatic or with
atypical presentation: falls, gait disorders and confusion.
Psychotropic agents (antipsychotics, sedatives, antidepressants),
and cardiovascular drugs (antihypertensive
agents, vasodilators, diuretics) were associated with OH.
Discussion: If the hypothesis of causality between
drug treatment and OH is confirmed, the identification of
the involved drugs could be of value for the prevention
of OH and its complications. In this context, the Working
Group Pharmacology Pharmacotherapy and Pharmaceutical
Care of the Belgian Society of Gerontology and Geriatrics
proposes to conduct a multicentre study to assess
the prevalence of OH in Belgian acute geriatrics units and
its relationship with drugs.
ISSN: 1784-3286
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Academic Center for General Practice
× corresponding author
# (joint) last author

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