Orthostatic hypotension in the elderly.

ORTHOSTATIC hypotension is often observed in elderly people and may result in substantial morbidity and mortality from associated falls and syncope. Studies of elderly people living in the community have found a prevalence of orthostatic hypotension as high as 20 percent among medical outpatients over 65 years of age1 , 2 and 30 percent among those over 75.1 However, recent epidemiologic studies of healthy, normotensive elderly subjects without known risk factors for orthostatic hypotension have found a prevalence of less than 7 percent.3 , 4 Data on blood pressure measured in the supine and sitting positions in over 8000 participants in the National Health . . .

[1]  I. Kopin,et al.  The sympathetic-nervous-system defect in primary orthostatic hypotension. , 1977, The New England journal of medicine.

[2]  M. Blaufox,et al.  The association of postural changes in systolic blood pressure and mortality in persons with hypertension: the Hypertension Detection and Follow-up Program experience. , 1987, Circulation.

[3]  S. Smith Reduced sinus arrhythmia in diabetic autonomic neuropathy: diagnostic value of an age-related normal range. , 1982, British medical journal.

[4]  Crane Mg,et al.  Effect of aging on renin activity and aldosterone excretion. , 1976 .

[5]  L. Lipsitz,et al.  Cardiovascular and norepinephrine responses after meal consumption in elderly (older than 75 years) persons with postprandial hypotension and syncope. , 1986, The American journal of cardiology.

[6]  A. Mark The Bezold-Jarisch reflex revisited: clinical implications of inhibitory reflexes originating in the heart. , 1983, Journal of the American College of Cardiology.

[7]  A N Exton-Smith,et al.  Functional changes in autonomic nervous responses with ageing. , 1980, Age and ageing.

[8]  A. Hollister,et al.  Clonidine raises blood pressure in severe idiopathic orthostatic hypotension. , 1983, The American journal of medicine.

[9]  H. Itskovitz,et al.  TREATMENT OF IDIOPATHIC ORTHOSTATIC HYPOTENSION (SHY-DRAGER SYNDROME) WITH INDOMETHACIN , 1978, The Lancet.

[10]  L. Rubenstein,et al.  Effect of Timing and Number of Baseline Blood Pressure Determinations on Postural Blood Pressure Response , 1989, Journal of the American Geriatrics Society.

[11]  R. Hoeldtke,et al.  Treatment of postprandial hypotension with a somatostatin analogue (SMS 201-995). , 1986, The American journal of medicine.

[12]  L. Wollner,et al.  Reduced thirst after water deprivation in healthy elderly men. , 1984, The New England journal of medicine.

[13]  J. Rowe,et al.  Sympathetic nervous system and aging in man. , 1980, Endocrine reviews.

[14]  R. Hoeldtke,et al.  Treatment of orthostatic hypotension with dihydroergotamine and caffeine. , 1986, Annals of internal medicine.

[15]  D. Kennedy,et al.  Postural hypotension and diuretic therapy in the elderly. , 1978, Canadian Medical Association journal.

[16]  Orthostatic hypotension. II. Clinical diagnosis, testing, and treatment. , 1984, Archives of internal medicine.

[17]  L. Wollner,et al.  Failure of cerebral autoregulation as a cause of brain dysfunction in the elderly. , 1979, British medical journal.

[18]  M. Nathan,et al.  Comparison of 1-hour and 24-hour blood pressure recordings in central or peripheral baroreceptor-denervated rats. , 1986, Hypertension.

[19]  T. Blaschke,et al.  Decline in beta adrenergic receptor-mediated vascular relaxation with aging in man. , 1986, The Journal of pharmacology and experimental therapeutics.

[20]  J. Halter,et al.  Age differences in plasma norepinephrine kinetics in humans. , 1986, Journal of gerontology.

[21]  J. Wei,et al.  Syncope in institutionalized elderly: the impact of multiple pathological conditions and situational stress. , 1986, Journal of chronic diseases.

[22]  P. Weidmann,et al.  Effects of posture and ageing on circulating atrial natriuretic peptide levels in man. , 1987, Journal of hypertension.

[23]  L. Lipsitz,et al.  Intra-individual variability in postural blood pressure in the elderly. , 1985, Clinical science.

[24]  I. Kopin,et al.  Pharmacologic distinction of different orthostatic hypotension syndromes , 1981, Neurology.

[25]  D Robertson,et al.  Management of chronic orthostatic hypotension. , 1986, American Journal of Medicine.

[26]  P. Dupui,et al.  Cerebral Blood Flow in Aging , 1984 .

[27]  A Pomerance,et al.  Human aging: changes in structure and function. , 1987, Journal of the American College of Cardiology.

[28]  S. Strandgaard,et al.  Autoregulation of Cerebral Blood Flow in Hypertensive Patients: The Modifying Influence of Prolonged Antihypertensive Treatment on the Tolerance to Acute, Drug‐induced Hypotension , 1976, Circulation.

[29]  J. Timothy,et al.  Postural hypotension in old age: is it a disorder of the nervous system or of blood vessels? , 1980, Age and ageing.

[30]  J. Rowe,et al.  The effect of age and sodium depletion on cardiovascular response to orthostasis. , 1986, Hypertension.

[31]  J. Floras,et al.  Consequences of impaired arterial baroreflexes in essential hypertension: effects on pressor responses, plasma noradrenaline and blood pressure variability. , 1988, Journal of hypertension.

[32]  T. A. Anderson,et al.  The effect of dietary sodium chloride on blood pressure, body fluids, electrolytes, renal function, and serum lipids of normotensive man. , 1976, The Journal of laboratory and clinical medicine.

[33]  W. Abelmann,et al.  Impaired orthostatic tolerance after bed rest in patients with myocardial infarction. , 1969 .

[34]  J. Onrot,et al.  The potent pressor effect of phenylpropanolamine in patients with autonomic impairment. , 1987, JAMA.

[35]  George A. Williams,et al.  Effect of aging on left ventricular diastolic filling in normal subjects. , 1987, The American journal of cardiology.

[36]  L. Rubenstein,et al.  Low prevalence of postural hypotension among community-dwelling elderly. , 1987, JAMA.

[37]  I J Schatz,et al.  Orthostatic Hypotension: I. Functional and Neurogenic Causes , 1984 .

[38]  M. Yahr,et al.  Treatment of orthostatic hypotension due to autonomic failure with a peripheral alpha‐adrenergic agonist (midodrine) , 1988, Neurology.

[39]  M. Tinetti,et al.  Fall risk index for elderly patients based on number of chronic disabilities. , 1986, The American journal of medicine.

[40]  R. Feldman,et al.  Alterations in leukocyte β-receptor affinity with aging: a potential explanation for altered β-adrenergic sensitivity in the elderly , 1984 .

[41]  R. D. Kennedy,et al.  Effect of posture on blood pressure in the elderly. , 1973, British heart journal.

[42]  J. Onrot,et al.  Hemodynamic and humoral effects of caffeine in autonomic failure. Therapeutic implications for postprandial hypotension. , 1985, The New England journal of medicine.