scholarly journals Orthostatic hypotension in older adults: the role of medications

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Giulia Rivasi ◽  
Andrea Ungar
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Orthostatic Hypotension ◽  
Blood Pressure Response ◽  
Blood Pressure Reduction ◽  
Pharmacological Therapy ◽  
Drug Classes ◽  
Orthostatic Blood Pressure ◽  
Psychoactive Medications

Orthostatic hypotension (OH) is defined as an abnormal blood pressure reduction when standing and is frequently diagnosed in older adults. Pharmacological therapy is one of the main causes of orthostatic blood pressure impairment, leading to iatrogenic OH. Indeed, several medications may induce hypotensive effects and influence the blood pressure response to orthostatism. Hypotensive medications may also overlap with other determinants of OH, thus increasing the burden of symptoms and the risk of complications. Potentially hypotensive medications include both cardiovascular and psychoactive drugs, which are frequently prescribed in older patients. According to the available evidence, the antihypertensive treatment “per se” does not seem to predispose to OH, even if a higher risk is associated with polypharmacy and drug classes such as with diuretics and vasodilators. As concerns psychoactive medications, OH is a well-known adverse effect of tricyclic antidepressants, trazodone and antipsychotics. The knowledge of hemodynamic consequences of drug therapy may be helpful to improve OH treatment. A medication review is advisable in all patients presenting with OH, particularly at advanced age, aiming at optimizing medical treatment with a view to minimize the risk of iatrogenic OH.

scholarly journals Orthostatic Hypotension and Novel Blood Pressure Associated Gene Variants in Older Adults: Data From the TILDA Study

2019 ◽  
Vol 75 (11) ◽  
pp. 2074-2080
Author(s):  
Eamon Laird ◽  
Aisling M O’halloran ◽  
Artur Fedorowski ◽  
Olle Melander ◽  
Ann Hever ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Logistic Regression ◽  
Orthostatic Hypotension ◽  
Genetic Variants ◽  
Incidence Rate Ratio ◽  
Nucleotide Polymorphism ◽  
Single Nucleotide ◽  
Increased Risk ◽  
Orthostatic Blood Pressure

Abstract Orthostatic hypotension (OH) is associated with increased risk of trauma and cardiovascular events. Recent studies have identified new genetic variants that influence orthostatic blood pressure (BP). The aim of this study was to investigate the associations of candidate gene loci with orthostatic BP responses in older adults. A total of 3,430 participants aged ≥50 years from The Irish Longitudinal Study on Ageing (TILDA) with BP measures and genetic data from 12 single-nucleotide polymorphism (SNP) linked to BP responses were analyzed. Orthostatic BP responses were recorded at each 10 s interval and were defined as OH (SBP drop ≥20 mmHg or DBP drop ≥10 mmHg) at the time-points 40, 90, and 110 s. We defined sustained OH (SOH) as a drop that exceeded consensus BP thresholds for OH at 40, 90, and 110 s after standing. Logistic regression analyses modeled associations between the candidate SNP alleles and OH. We report no significant associations between OH and measured SNPs after correction for multiple comparisons apart from the SNP rs5068 where proportion of the minor allele was significantly different between cases and controls for SOH 40 (p = .002). After adjustment for covariates in a logistic regression, those with the minor G allele (compared to the A allele) had a decreased incidence rate ratio (IRR) for SOH 40 (IRR 0.45, p = .001, 95% CI 0.29–0.72). Only one SNP linked with increased natriuretic peptide concentrations was associated with OH. These results suggest that genetic variants may have a weak impact on OH but needs verification in other population studies.

PENGARUH PEMBERIAN BELIMBING DAN MENTIMUN TERHADAP PENDERITA HIPERTENSI DI DESA LAU KERSIK KECAMATAN GUNUNG SITEMBER KABUPATEN DAIRI

2019 ◽  
Vol 2 (1) ◽  
pp. 18-23
Author(s):  
Herri Novita Br Tarigan ◽  
Prista Hotmarina Purba
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
Fruit Juice ◽  
Blood Pressure Reduction ◽  
Reduce Blood Pressure ◽  
Pharmacological Therapy ◽  
Hypertensive Patients ◽  
Star Fruit ◽  
Equivalent Time ◽  
Life Threatening

Hypertension is a disease that is not uncommon in the community, including the Bukit Lau Kersik village. People with hypertension often do not show long-term symptoms and can be life-threatening. However, one of the management of hypertension that can be used as non-pharmacological therapy is consuming starfruit juice and cucumber which is quite easy to find in the Bukit Lau Kersik village. This combination of juices contains potassium which can reduce blood pressure in patients with hypertension. This study used Equivalent Time Sample Design with 14 subjects with hypertension in the Bukit Lau Kersik Village, Gunung Sitember Subdistrict, Dairi District. The technique of this research sample used Non-Probability Sampling with Saturated Sampling. The instrument used was a sphygmomanometer and a stethoscope. Bivariate data analysis in this study was the Wilcoxon statistical test. Based on the data analysis performed, the value of p = 0.011 (p= < 0.05) was obtained, meaning that there was a significant relationship between giving star fruit juice and cucumber to hypertensive patients. Then it can be concluded that there is an influence between giving star fruit and cucumber juice to blood pressure reduction in hypertensive patients in Bukit Lau Kersik Village Gunung Sitember Subdistrict, Dairi District in 2019. Suggestion: The factors that affect blood pressure in hypertensive patients and checking blood pressure before drinking star fruit juice and cucumber.

Acute Blood Pressure Response to High- and Moderate-Speed Resistance Exercise in Older Adults With Hypertension

2021 ◽  
pp. 1-8
Author(s):  
Carlos Leonardo Figueiredo Machado ◽  
Régis Radaelli ◽  
Clarissa Muller Brusco ◽  
Eduardo Lusa Cadore ◽  
Eurico N. Wilhelm ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Resistance Exercise ◽  
Blood Pressure Response ◽  
Individual Response ◽  
Older Individuals ◽  
Repetition Maximum ◽  
Control Protocol ◽  
The Individual ◽  
And Control

An increase in blood pressure (BP) occurs during resistance exercise; attention to this response may be necessary in older individuals with hypertension. We compared the BP responses following high- (HSRE) and moderate-speed resistance exercise (MSRE) (4 × 8 repetitions at 60% one-repetition maximum) and control protocol in 15 older adults with hypertension. HSRE and MSRE increased systolic BP (SBP) by the end of each set compared with preexercise and control protocol. Immediately after the fourth set, a higher SBP was observed in MSRE than HSRE (147 ± 14 vs. 141 ± 12 mmHg; p = .01). Taking an exploratory analysis of the individual response, we observed that MSRE resulted in greater mean changes and number of SBP exposures to values ≥150 mmHg (22-fold) than HSRE (10-fold). Diastolic BP increased (p < .05) with exercise, but only MSRE increased compared with the control condition (p < .05). HSRE may be an alternative for individuals in which SBP peak should be avoided.

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