Orthostatic Hypotension in the Elderly

New England Journal of Medicine

Volumn 321, Issue 14, 1989, Pages 952-957

  Desforges, Jane F ^a   Lipsitz, Lewis A ^b,c,d,e  

^a Hebrew Rehabilitation Center for Aged ^*

^b RESEARCH AND TRAINING INSTITUTE   (United States)

^c Brigham and Womens' Hospital   (United States)

^d Harvard Medical School ^*  (United States)

^e HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CAFFEINE; CLONIDINE; FLUDROCORTISONE ACETATE; MIDODRINE; PHENYLPROPANOLAMINE; PINDOLOL; POTASSIUM; PROPRANOLOL; SOMATOSTATIN; YOHIMBINE;

AGED; BLOOD PRESSURE; HUMAN; ORTHOSTATIC HYPOTENSION; PATHOPHYSIOLOGY; PRIORITY JOURNAL; SUPPLEMENTATION; REVIEW;

AGED; HUMAN; HYPOTENSION, ORTHOSTATIC; SUPPORT, NON-U.S. GOV'T; SUPPORT, U.S. GOV'T, P.H.S.;

EID: 0024962499     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJM198910053211407     Document Type: Review

References (50)

1. Caird FI, Andrews GR, Kennedy RD. Effect of posture on blood pressure in the elderly. Br Heart J 1973; 35: 527–30.
2. MacLennan WJ, Hall MR, Timothy JI. Postural hypotension in old age: is it a disorder of the nervous system or of blood vessels? Age aging 1980; 12: 25–32.
3. Myers MG, Kearns PM, Kennedy DS, Fisher RH. Postural hypotension and diuretic therapy in the elderly. Can Med Assoc J 1978; 119: 581–4.
4. Mader SL, Josephson KR, Rubenstein LZ. Low prevalence of postural hypotension among community-dwelling elderly. JAMA 1987; 258: 1511–4.
5. Harris T, Kleinman J, Lipsitz L, Cornoni-Huntley J, Garrison R. Is age or level of systolic blood pressure related to positional blood pressure change? Gerontologist 1986; 26: Suppl: 59A.
6. Lipsitz LA, Storch HA, Minaker KL, Rowe JW. Intra-individual variability in postural blood pressure in the elderly. Clin Sci 1985; 69: 337–41.
7. Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med 1986; 80: 429–34.
8. Lipsitz LA, Pluchino FC, Wei JY, Rowe JW. Syncope in institutionalized elderly: the impact of multiple pathological conditions and situational stress. J Chronic Dis 1986; 39: 619–30.
9. Davis BR, Langford HG, Blaufox MD, Curb JD, Polk BF, Shulman NB. The association of postural changes in systolic blood pressure and mortality in persons with hypertension: the Hypertension Detection and Follow-up Program experience. Circulation 1987; 75: 340–6.
10. Eckberg D-L. Parasympathetic cardiovascular control in human disease: a critical review of methods and results. Am J Physiol 1980; 239: H581H593.
11. Collins KJ, Exton-Smith AN, James MH, Oliver DJ. Functional changes in autonomic nervous responses with aging. Age aging 1980; 9: 1724.
12. Minaker KL, Rowe JW, Sparrow D. Impaired cardiovascular adaptation to vasodilation in the elderly. Gerontologist 1980; 20(5 Part II):163. abstract.
13. Veith RC, Featherstone JA, Linares OA, Halter JB. Age differences in plasma norepinephrine kinetics in humans. J Gerontol 1986; 41: 319–24.
14. Rowe JW, Troen BR. Sympathetic nervous system and aging in man. Endocr Rev 1980; 1: 167–79.
15. Feldman RD, Limbird LE, Nadeau J, Robertson D, Wood AJJ. Alterations in leukocyte β-receptor affinity with aging: a potential explanation for altered β-adrenergic sensitivity in the elderly. N Engl J Med 1984; 310: 815–9.
16. Pan HY, Hoffman BB, Pershe RA, Blaschke TF. Decline in beta adrenergic receptor-mediated vascular relaxation with aging in man. J Pharmacol Exp Ther 1986; 239: 802–7.
17. Lakatta EG, Mitchell JH, Pomerance A, Rowe GG. Human aging: changes in structure and function. J Am Coll Cardiol 1987; 10: 42A–47A.
18. Bryg RJ, Williams GA, Labovitz AF. Effect of aging on left ventricular diastolic filling in normal subjects. Am J Cardiol 1987; 59: 971–4.
19. Shannon RP, Wei JY, Rosa RM, Epstein FH, Rowe JW. The effect of age and sodium depletion on cardiovascular response to orthostasis. Hypertension 1986; 8: 438–43.
20. Kannel WB. Hypertension and aging. In: Finch CE, Schneider EL, eds. Handbook of the biology of aging. 2nd ed. New York: Van Nostrand Reinhold, 1985:859–63.
21. Lakatta EG. Do hypertension and aging have a similar effect on the myocardium? Circulation 1987; 75: 169–77.
22. Meyer JS, Shaw TG. Cerebral blood flow in aging. In: Albert ML, ed. Clinical neurology of aging. New York: Oxford University Press, 1984:178–96.
23. Wollner L, McCarthy ST, Soper ND, Macy DJ. Failure of cerebral autoregulation as a cause of brain dysfunction in the elderly. Br Med J 1979; 1: 1117–8.
24. Strandgaard S. Autoregulation of cerebral blood flow in hypertensive patients: the modifying influence of prolonged antihypertensive treatment on the tolerance to acute, drug-induced hypotension. Circulation 1976; 53: 720–7.
25. Buchholz RA, Hubbard JW, Nathan MA. Comparison of 1-hour and 24–hour blood pressure recordings in central or peripheral baroreceptor-denervated rats. Hypertension 1986; 8: 1154–63.
26. Floras JS, Hassan MO, Jones JV, Osikowska BA, Sever PS, Sleight P. Consequences of impaired arterial baroreflexes in essential hypertension: effects on pressor responses, plasma noradrenaline and blood pressure variability. J Hypertens 1988; 6: 525–35.
27. Crane MG, Harris JJ. Effect of aging on renin activity and aldosterone excretion. J Lab Clin Med 1976; 87: 947–59.
28. Epstein M, Hollenberg NK. Age as a determinant of renal sodium conservation in normal man. J Lab Clin Med 1976; 87: 411–7.
29. Haller BG, Zust H, Shaw S, Gnadinger MP, Uehlinger DE, Weidmann P. Effects of posture and aging on circulating atrial natriuretic peptide levels in man. J Hypertens 1987; 5: 551–6.
30. Phillips PA, Rolls BJ, Ledingham JGG, et al. Reduced thirst after water deprivation in healthy elderly men. N Engl J Med 1984; 311: 753–9.
31. Fareeduddin K, Abelmann WH. Impaired orthostatic tolerance after bed rest in patients with myocardial infarction. N Engl J Med 1969; 280: 345–50.
32. Ziegler MG, Lake CR, Kopin IJ. The sympathetic-nervous-system defect in primary orthostatic hypotension. N Engl J Med 1977; 296: 293–7.
33. Polinsky RJ, Kopin IJ, Ebert MH, Weise V. pharmacologic distinction of different orthostatic hypotension syndromes. Neurology 1981; 31: 1–7.
34. Schatz IJ. Orthostatic hypotension. I. Function and neurogenic causes. Arch Intern Med 1984; 144: 773–7.
35. Lipsitz LA, Pluchino FC, Wei JY, Minaker KL, Rowe JW. Cardiovascular and norepinephrine responses following meal consumption in elderly (older than 75 years) persons with post-prandial hypotension and syncope. Am J Cardiol 1986; 58: 810–5.
36. Mader SL, Palmer RM, Rubenstein LZ. Effect of timing and number of baseline blood pressure determinations on postural blood pressure response. J Am Geriatr Soc 1989; 37: 444–6.
37. Kennedy GT, Crawford MH. Optimal position and timing of blood pressure and heart rate measurements to detect orthostatic changes in patients with ischemic heart disease. J Cardiac Rehabil 1984; 4: 219–23.
38. Mark AL. The Bezold–Jarisch reflex revisited: clinical implications of inhibitory reflexes originating in the heart. J Am Coll Cardiol 1983; 1: 90–102.
39. Smith SA. Reduced sinus arrhythmia in diabetic autonomic neuropathy: diagnostic value of an age-related normal range. Br Med J 1982; 285: 1599–601.
40. Ewing DJ. Practical bedside investigation of diabetic autonomic failure. In: Bannister R, ed. Autonomic failure: a textbook of clinical disorders of the autonomic nervous system. Oxford: Oxford University Press, 1983:372–6.
41. Sever PS. Plasma noradrenalin in autonomic failure. In: Bannister R, ed. Autonomic failure: a textbook of clinical disorders of the autonomic nervous system. Oxford: Oxford University Press, 1983:165–7.
42. Kochar MS, Itskovitz HD. Treatment of idiopathic orthostatic hypotension (Shy-Drager syndrome) with indomethacin. Lancet 1978; 1: 1011–4.
43. Robertson D, Goldberg MR, Hollister AS, Wade D, Robertson RM. Clonidine raises blood pressure in severe idiopathic orthostatic hypotension. Am J Med 1983; 74: 193–200.
44. Schatz IJ. Orthostatic hypotension. II. Clinical diagnosis, testing, and treatment. Arch Intern Med 1984; 144: 1037–41.
45. Onrot J, Goldberg MR, Hollister AS, Biaggioni I, Robertson RM, Robertson D. Management of chronic orthostatic hypotension. Am J Med 1986; 80: 454–64.
46. Biaggioni I, Onrot J, Steward CK, Robertson D. The potent pressor effect of phenylpropanolamine in patients with autonomic impairment. JAMA 1987; 258: 236–9.
47. Kaufmann H, Brannan T, Krakoff L, Yahr MD, Mandeli J. Treatment of orthostatic hypotension due to autonomic failure with a peripheral alpha-adrenergic agonist (midodrine). Neurology 1988; 38: 951–6.
48. Onrot J, Goldberg MR, Biaggioni I, Hollister AS, Kincaid D, Robertson D. Hemodynamic and humoral effects of caffeine in autonomic failure: therapeutic implications for postprandial hypotension. N Engl J Med 1985; 313: 549–54.
49. Hoeldtke RD, Cavanaugh ST, Hughes JD, Polansky M. Treatment of orthostatic hypotension with dihydroergotamine and caffeine. Ann Intern Med 1986; 105: 168–73.
50. Hoeldtke RD, Boden G, O'Dorisio TM. Treatment of postprandial hypotension with a somatostatin analogue (SMS 201–995). Am J Med 1986; 81: 83–7.