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Pharmacological options in the management of orthostatic hypotension in older adults.
Expert Rev Cardiovasc Ther. 2009 Nov; 7(11):1395-400.ER

Abstract

Orthostatic hypotension (OH) is a common disorder in older adults with potentially serious clinical consequences. Understanding the key underlying pathophysiological processes that predispose individuals to OH is essential when making treatment decisions for this group of patients. In this article, we discuss the key antihypotensive agents used in the management of OH in older adults. Commonly, midodrine is used as a first-line agent, given its supportive data in randomized, controlled trials. Fludrocortisone has been evaluated in open-label trials and has long-established usage in clinical practice. Other agents are available and in clinical use, either alone or in combination, but larger randomized trial evaluations are yet to be published. It is important to bear in mind that a patient may be taking medications that predispose to or exacerbate the symptoms of OH. Withdrawal of such medications, where possible, should be considered before commencing other pharmacological agents that attenuate the symptoms of OH.

Authors+Show Affiliations

Department of Geriatric Medicine, Beaumont Hospital, Dublin 9, Ireland.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19900022

Citation

Kearney, Fiona, and Alan Moore. "Pharmacological Options in the Management of Orthostatic Hypotension in Older Adults." Expert Review of Cardiovascular Therapy, vol. 7, no. 11, 2009, pp. 1395-400.
Kearney F, Moore A. Pharmacological options in the management of orthostatic hypotension in older adults. Expert Rev Cardiovasc Ther. 2009;7(11):1395-400.
Kearney, F., & Moore, A. (2009). Pharmacological options in the management of orthostatic hypotension in older adults. Expert Review of Cardiovascular Therapy, 7(11), 1395-400. https://doi.org/10.1586/erc.09.130
Kearney F, Moore A. Pharmacological Options in the Management of Orthostatic Hypotension in Older Adults. Expert Rev Cardiovasc Ther. 2009;7(11):1395-400. PubMed PMID: 19900022.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacological options in the management of orthostatic hypotension in older adults. AU - Kearney,Fiona, AU - Moore,Alan, PY - 2009/11/11/entrez PY - 2009/11/11/pubmed PY - 2010/2/24/medline SP - 1395 EP - 400 JF - Expert review of cardiovascular therapy JO - Expert Rev Cardiovasc Ther VL - 7 IS - 11 N2 - Orthostatic hypotension (OH) is a common disorder in older adults with potentially serious clinical consequences. Understanding the key underlying pathophysiological processes that predispose individuals to OH is essential when making treatment decisions for this group of patients. In this article, we discuss the key antihypotensive agents used in the management of OH in older adults. Commonly, midodrine is used as a first-line agent, given its supportive data in randomized, controlled trials. Fludrocortisone has been evaluated in open-label trials and has long-established usage in clinical practice. Other agents are available and in clinical use, either alone or in combination, but larger randomized trial evaluations are yet to be published. It is important to bear in mind that a patient may be taking medications that predispose to or exacerbate the symptoms of OH. Withdrawal of such medications, where possible, should be considered before commencing other pharmacological agents that attenuate the symptoms of OH. SN - 1744-8344 UR - https://www.unboundmedicine.com/medline/citation/19900022/Pharmacological_options_in_the_management_of_orthostatic_hypotension_in_older_adults_ L2 - https://www.tandfonline.com/doi/full/10.1586/erc.09.130 DB - PRIME DP - Unbound Medicine ER -