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Orthostatic hypotension in older patients

Published online by Cambridge University Press:  01 November 2007

Fiona Kearney
Affiliation:
Beaumont Hospital, Dublin, Ireland
Alan Moore*
Affiliation:
Beaumont Hospital, Dublin, Ireland
Ciaran Donegan
Affiliation:
Beaumont Hospital, Dublin, Ireland
*
Address for correspondence: A Moore, Dept of Geriatric Medicine, Beaumont Hospital, Dublin 9, Ireland.

Extract

Orthostatic hypotension (OH) is a clinical condition which frequently results in troublesome symptoms such as dizziness, giddiness, blurred vision and light-headedness. It is a common disorder associated with an increased risk of falling, especially in older individuals. OH is the presenting haemodynamic manifestation of several different and diverse underlying pathological conditions, including disorders of blood pressure (BP) regulation and disorders leading to reduced intravascular volume. In younger and middle-aged adults, the presence of OH should not be considered a primary diagnosis in itself but rather a starting point in the diagnostic pathway before the primary underlying abnormality has been identified. In older patients however, asymptomatic blood pressure drops are very frequently encountered so that, in certain cases, an exhaustive diagnostic search for an underlying cause is not warranted. However, reversible causes of OH do frequently exist in older patients. Prominent among these are the use of several commonly prescribed cardiovascular drugs and vitamin B12 deficiency.

Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 2008

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