Orthostatic hypotension in a cohort of hypertensive patients referring to a hypertension clinic

Abstract

The prevalence of orthostatic hypotension (OH) in hypertensive patients ranges from 3 to 26%. Drugs are a common cause of non-neurogenic OH. In the present study, we retrospectively evaluated the medical records of 9242 patients with essential hypertension referred to our Hypertension Unit. We analysed data on supine and standing blood pressure values, age, sex, severity of hypertension and therapeutic associations of drugs, commonly used in the treatment of hypertension. OH was present in 957 patients (10.4%). Drug combinations including α-blockers, centrally acting drugs, non-dihydropyridine calcium-channel blockers and diuretics were associated with OH. These pharmacological associations must be administered with caution, especially in hypertensive patients at high risk of OH (elderly or with severe and uncontrolled hypertension). Angiotensin-receptor blocker (ARB) seems to be not related with OH and may have a potential protective effect on the development of OH.

Determining the prevalence of orthostatic hypotension and its associations with hypertension and functional decline in the community-dwelling elderly in Vietnam

“…Aging and hypertension are associated with a decrease in baroreflex-mediated cardio acceleration and vasoconstriction, impaired renal salt and water conservation; slow cardiac filling 29 and impairment of compensatory mechanisms is exaggerated with uncontrolled hypertension. 30 This finding is in agreement with the previous studies 19,31 in which the achievement of BP control decreased the risk of OH.…”

“…1 The difference in the prevalence of OH between studies was due to methodological differences such as positions of participants when blood pressure was measured, supine to standing or seated to standing as well as the definition of OH, one or three min after standing up. In our study, blood pressure was measured at seated position and at the third minute of standing, while in other studies, 19,20 blood pressure was evaluated at supine position and standing at one, two or three min. Supine to standing blood pressure-measurements provoke a greater reduction in blood pressure and increase the prevalence of OH when compared with seated to standing posture changes.…”

“…26,27 This implies the significance of screening OH in older population even if they are asymptomatic, especially in hypertensive ones. Moreover, some types of medications 19 may exacerbate OH such as diuretics, alpha blockers, medications for Parkinson's disease, etc. ; therefore, patients should be screened for OH before receiving treatment.…”

Ortostatinės Hipotenzijos Paplitimas Tarp Sergančiųjų Arterine Hipertenzija

“…iki 26 proc. [7]. Taip pat šiai studijai antrina 2013 m. atliktas prancūzų tyrimas, teigiantis, kad ortostatinės hipotenzijos rizika yra 35 proc.…”

“…2015 m. atlikta studija teigia, kad pacientai, sergantys ortostatine hipotenzija, dažniausiai vartoja kelių vaistų derinį gretutinėms ligoms gydyti (pvz., β adrenoblokatorius, kalcio kanalų blokatorius, diuretikus ir kt. ), bet nerasta ryšio tarp angiotenzino receptorių blokatorių vartojimo ir ortostatinės hiporenzijos pasireiškimo [7]. Mūsų tyrimo respondentai teigė, kad net 84,25 proc.…”