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Orthostatic Hypotension (Described Concisely)
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Orthostatic hypotension (OH) is very common in older people and is encountered daily in emergency departments and medical admissions units. It is associated with a higher risk of falls, fractures, dementia and death, so prompt recognition and treatment are essential.Progressive orthostatic hypotension is commonly seen in the elderly because of age-related impairment in baroreflex compensatory reflexes to upright position.
- Anemia or vitamin B12 deficiency.
- Dehydration from diarrhea, vomiting or diuretics.
- Endocrine problems, including diabetes, thyroid disease and Addison’s disease.
- Heart conditions, including arrhythmias and heart valve disease.
When should I be concerned about orthostatic hypotension?
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Orthostatic hypotension can be mild. Episodes might be brief. However, long-lasting orthostatic hypotension can signal more-serious problems. It’s important to see a health care provider if you frequently feel lightheaded when standing up.
Should I go to the ER for orthostatic hypotension?
Contact your physician. This type of problem usually cannot be managed in the office unless they have a nurse who can do IVs. If it is after clinic hours, consider a visit to the ER for evaluation and IV fluids. Even if you get IV fluids and they help, sometimes it takes the body 24-48 hours to readjust to the fluids.
Why do I suddenly have orthostatic hypotension?
Health conditions that can cause orthostatic hypotension include: Heart issues, including heart valve disease, bradycardia (a type of arrhythmia), heart attack and heart failure. Endocrine problems, including diabetes, thyroid disease and Addison’s disease. Neurological issues, including Parkinson’s disease and …
What should I do if I have orthostatic hypotension?
- Wearing waist-high compression stockings. These may help improve blood flow and reduce the symptoms of orthostatic hypotension. …
- Getting plenty of fluids. …
- Avoiding alcohol. …
- Increasing salt in the diet. …
- Eating small meals. …
- Exercising. …
- Moving and stretching in certain ways. …
- Getting up slowly.
Why is orthostatic hypotension common in elderly?
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Progressive orthostatic hypotension is commonly seen in the elderly because of age-related impairment in baroreflex compensatory reflexes to upright position.
How does age influence orthostatic hypotension?
With age our ability to maintain haemodynamic homeostasis during position changes becomes less effective. This predisposes elderly patients to significant changes in blood pressure upon standing and orthostatic hypotension (OH).
What is the most common cause of hypotension in the elderly?
Causes include dehydration, long-term bed rest, pregnancy, certain medical conditions and some medications. This type of low blood pressure is common in older adults.
Is orthostatic hypotension more common in older adults?
Orthostatic hypotension (OH) is very common in older people and is encountered daily in emergency departments and medical admissions units. It is associated with a higher risk of falls, fractures, dementia and death, so prompt recognition and treatment are essential.
What conditions produce orthostatic hypotension in the elderly?
- Anemia or vitamin B12 deficiency.
- Dehydration from diarrhea, vomiting or diuretics.
- Endocrine problems, including diabetes, thyroid disease and Addison’s disease.
- Heart conditions, including arrhythmias and heart valve disease.
How is orthostatic hypotension treated in the elderly?
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In most cases, treatment of orthostatic hypotension begins with nonpharmacological interventions, including withdrawal of offending medications (when feasible), physical maneuvers, compression stockings, increased intake of salt and water, and regular exercise.
Is orthostatic hypotension normal in elderly?
Orthostatic hypotension is a common problem among elderly patients, associated with significant morbidity and mortality.
What is a simple treatment for orthostatic hypotension?
For mild orthostatic hypotension, one of the simplest treatments is to sit or lie back down immediately after feeling lightheaded upon standing. Often, symptoms will disappear. Sometimes, medications are needed to treat orthostatic hypotension.
What is the best medicine for orthostatic hypotension?
Patients with chronic orthostatic hypotension should be counseled to avoid large carbohydrate-rich meals, limit alcohol intake, and ensure adequate hydration. Fludrocortisone, midodrine, and pyridostigmine (Mestinon) are effective therapies for chronic orthostatic hypotension.
How do you treat hypotension in the elderly?
- Use more salt. Experts usually recommend limiting salt (sodium) because it can raise blood pressure, sometimes dramatically. …
- Drink more water. Fluids increase blood volume and help prevent dehydration, both of which are important in treating hypotension.
- Wear compression stockings. …
- Medications.
What conditions produce orthostatic hypotension in the elderly?
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- Anemia or vitamin B12 deficiency.
- Dehydration from diarrhea, vomiting or diuretics.
- Endocrine problems, including diabetes, thyroid disease and Addison’s disease.
- Heart conditions, including arrhythmias and heart valve disease.
What causes orthostatic hypotension in elderly patients?
While acute orthostatic hypotension is usually secondary to medication, fluid or blood loss, or adrenal insufficiency, chronic orthostatic hypotension is frequently due to altered blood pressure regulatory mechanisms and autonomic dysfunction.
What is the most common cause of hypotension in elderly?
Causes include dehydration, long-term bed rest, pregnancy, certain medical conditions and some medications. This type of low blood pressure is common in older adults.
What other common condition can be attributed to orthostatic hypotension?
Orthostatic hypotension can be a risk factor for cardiovascular diseases and complications, such as chest pain, heart failure or heart rhythm problems.
What neurological conditions cause orthostatic hypotension?
Neurogenic orthostatic hypotension (nOH) results from impaired vasoconstriction due to dysfunction of the autonomic nervous system and is commonly associated with Parkinson disease (PD), multiple system atrophy (MSA), and pure autonomic failure.
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