Drug-Related Orthostatic Hypotension: Beyond Anti-Hypertensive Medications.
Accidental Falls
/ statistics & numerical data
Antihypertensive Agents
/ adverse effects
Blood Pressure
/ drug effects
Cognitive Dysfunction
/ epidemiology
Comorbidity
Diuretics
/ adverse effects
Female
Humans
Hypotension, Orthostatic
/ chemically induced
Psychotropic Drugs
/ adverse effects
Risk Factors
Syncope
/ epidemiology
Journal
Drugs & aging
ISSN: 1179-1969
Titre abrégé: Drugs Aging
Pays: New Zealand
ID NLM: 9102074
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
pubmed:
8
9
2020
medline:
21
1
2021
entrez:
7
9
2020
Statut:
ppublish
Résumé
Orthostatic hypotension (OH) is an abnormal blood pressure response to standing, which is associated with an increased risk of adverse outcomes such as syncope, falls, cognitive impairment, and mortality. Medical therapy is one the most common causes of OH, since numerous cardiovascular and psychoactive medications may interfere with the blood pressure response to standing, leading to drug-related OH. Additionally, hypotensive medications frequently overlap with other OH risk factors (e.g., advanced age, neurogenic autonomic dysfunction, and comorbidities), thus increasing the risk of symptoms and complications. Consequently, a medication review is recommended as a first-line approach in the diagnostic and therapeutic work-up of OH, with a view to minimizing the risk of drug-related orthostatic blood pressure impairment. If symptoms persist after the review of hypotensive medications, despite adherence to non-pharmacological interventions, specific drug treatment for OH can be considered. In this narrative review we present an overview of drugs acting on the cardiovascular and central nervous system that may potentially impair the orthostatic blood pressure response and we provide practical suggestions that may be helpful to guide medical therapy optimization in patients with OH. In addition, we summarize the available strategies for drug treatment of OH in patients with persistent symptoms despite non-pharmacological interventions.
Identifiants
pubmed: 32894454
doi: 10.1007/s40266-020-00796-5
pii: 10.1007/s40266-020-00796-5
pmc: PMC7524811
doi:
Substances chimiques
Antihypertensive Agents
0
Diuretics
0
Psychotropic Drugs
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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