Screening for orthostatic hypotension in the geriatric population in a real-world primary care setting reduces prescribed antihypertensive medications.
Blood Press Monit
; 28(6): 338-342, 2023 Dec 01.
Article
en En
| MEDLINE
| ID: mdl-37661718
ABSTRACT
BACKGROUND:
To determine if outpatient screening for orthostatic hypotension (OH) in the geriatric population results in fewer prescribed antihypertensive medications and if a relationship exists between OH and specific pharmacologic classes of antihypertensive medications. MATERIALS ANDMETHODS:
Patients ≥ 65 years were screened for OH, defined as a decrease in systolic blood pressure (SBP)â ≥â 20â mm Hg or a decrease in diastolic blood pressure (DBP)â ≥â 10â mm Hg after standing for 3 minutes. Sitting blood pressure (BP) was measured after patients had been seated quietly in an exam room. Patients then stood for approximately 3 minutes at which time standing BP was recorded.RESULTS:
OH prevalence was 18%. Standing DBP was significantly different between the two groups (70â mmHg ± 18, 80â mmHg ± 13, P â =â 0.007). Compared to patients without OH, patients with OH were more likely to have been previously prescribed beta-blockers (56% vs. 32%, P â =â 0.056) and potassium-sparing diuretics (11% vs. 1%, P â =â 0.026). Physicians discontinued an antihypertensive medication more often in patients who screened positive for OH than in to those who did not (17% vs. 4%, P â =â 0.037). Calcium channel blockers were the most frequently discontinued class of medication.CONCLUSION:
Asymptomatic OH is prevalent in geriatric patients. Screening for OH may lead to de-escalation of antihypertensive regimen and a reduction in polypharmacy. Positive screening for OH was associated with de-prescribing of antihypertensive medications. Prior use of beta-blockers and potassium-sparing diuretics was most largely associated with OH.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Hipertensión
/
Hipotensión Ortostática
Tipo de estudio:
Diagnostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Aged
/
Humans
Idioma:
En
Revista:
Blood Press Monit
Asunto de la revista:
ANGIOLOGIA
Año:
2023
Tipo del documento:
Article