JAMDA
Volume 7, Issue 3 , Pages 163-167 , March 2006

Orthostatic Hypotension in the Nursing Home Setting

  • Lukasz Iwanczyk, MD

      Affiliations

    • UCLA Multicampus Geriatrics Fellowship Program, Sepulveda, CA
    • Corresponding Author InformationAddress correspondence to Lukasz Iwanczyk, MD, UCLA Multicampus Geriatrics Fellowship Program, 16111 Plummer Street, Building 25 (11E), Sepulveda, VA 91343
    • ,
  • Nancy T. Weintraub, MD

      Affiliations

    • Sepulveda VA Geriatric Research, Education, and Clinical Center, Sepulveda, CA
    • ,
  • Laurence Z. Rubenstein, MD, MPH

      Affiliations

    • Greater Los Angeles VA GRECC, UCLA School of Medicine, Los Angeles, CA

References 

  1. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology . Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy . Neurology . 1996;46:1470–1471
  2. 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;37:444–446
  3. Myint S , Rodstein M , Neufeld RR , et al.   Orthostatic change in blood pressure in non-demented, ambulatory nursing home patients . Arch Gerontol Geriatr . 1992;14:123–129
  4. Valvanne J , Sorva A , Erkinjuntti  , et al.   The occurrence of postural hypotension in age cohorts of 75, 80, 85 years, a population study . Arch Gerontol Geriatr . 1991;(Suppl 2):421–424
  5. Strogatz DS , Keenan NL , Barnett EM , et al.   Correlates of postural hypotension in a community sample of elderly blacks and whites . J Am Geriatr Soc . 1991;39:562–566
  6. Mader SL , Josephson KR , Rubenstein LZ . Low prevalence of postural hypotension among community dwelling elderly . JAMA . 1987;258:1511–1514
  7. Palmer KT . Studies into postural hypotension in the elderly . N Z Med J . 1983;96:43–45
  8. Jonsson PV , Lipsitz LA , Kelley M , Koestner J . Hypotensive responses.to common daily activities in institutionalized elderly. A potential risk for recurrent falls . Arch Int Med . 1990;150:1518–1524
  9. Smith JJ , Porth CJ . Posture and the circulation (The age effect) . Exp Gerontol . 1991;26:141–162
  10. Williams BR , Nichol MB , Lowe B , et al.   Medication use in residential care facilities for the elderly . Ann Pharmacother . 1999;33:149–155
  11. Shaugnnessy PW , Schlenker RE , Polesovsky MB . Medicaid and non-Medicaid case mix differences in Colorado nursing homes . Med Care . 1986;24:482–495
  12. Gribbin B , Pickering TG , Sleight P , et al.   Effect of age and high blood pressure on baroreflex sensitivity in man . Circ Res . 1971;24:424–431
  13. Kamiya A , Michikami D , Fu Q , et al.   Pathophysiology of orthostatic hypotension after bed rest (Paradoxical sympathetic withdrawal) . Am J Physiol Heart Circ Physiol . 2003;285:H1158–H1167
  14. Kihara M , Mitsuo T , Kazuhiro N , et al.   Autonomic dysfunction in elderly bedfast patients . Age Ageing . 1998;27:551–555
  15. Rutan GH , Hermanson B , Bild DE , et al.   Orthostatic hypotension in older adults, the cardiovascular health study . Hypertension . 1992;19:508–519
  16. Low PA , Opfer-Gehrking TL , McPhee BR , et al.   Prospective evaluation of clinical characteristics of orthostatic hypotension . Mayo Clin Proc . 1995;70:617–622
  17. Ooi WL , Hossain M , Lipsitz LA . The association between orthostatic hypotension and recurrent falls in nursing home residents . Am J Med . 2000;108:106–111
  18. Overstall PW , Exton-Smith AN , Imms FJ , et al.   Falls in the elderly related to postural imbalance . BMJ . 1977;1:261–264
  19. Hines S , Houston M , Robertson D . The clinical spectrum of autonomic dysfunction . Am J Med . 1981;70:1091–1096
  20. Davis BR , Langford HG , Blaufox MD , 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) . Circulation . 1987;75:340–346
  21. Si M , Rodstein M , Neufeld R , et al.   Orthostatic change in blood pressure in non-demented, ambulatory nursing home patients . Arch Gerontol Geriatr . 1992;14:123–129
  22. Verhaeverbeke I , Mets T . Drug-induced orthostatic hypotension in the elderly, avoiding its onset . Drug Safety . 1997;17:105–118
  23. Grubb BP , Karas B . Clinical disorders of the autonomic nervous system associated with orthostatic intolerance (An overview of classification, clinical evaluation, and management) . Pacing Clin Electrophysiol . 1999;22:798–810
  24. Biaggioni I , Robertson RM . Hypertension in orthostatic hypotension and autonomic dysfunction . Cardiol Clin . 2002;20:291–301
  25. Fagan TC , Sawyer PR , Gourley LA , et al.   Postprandial alterations in hemodynamics and blood pressure in normal subjects . Am J Cardiol . 1986;58:636–641
  26. Cunha UV . Management of orthostatic hypotension in the elderly . Geriatrics . 1987;42:61–68
  27. Rowe HR , O’Mahoney DJ . Haemodynamic analysis of efficacy of compression hosiery in elderly fallers with orthostatic hypotension . Lancet . 1999;354:45–47
  28. Siker HO , Burnum JF , Hickman JB , et al.   Treatment of postural hypotension with a counterpressure garment . JAMA . 1956;161: 132
  29. Ziegler MG . Choosing therapy for postural hypotension . Drug Therapy Hospital . 1981;9:49–60
  30. Watt SJ , Tooke JE , Perkins CM , et al.   The treatement of idiopathic orthostatic hypotension (A combined fludrocortisone and Flurbiprofen regime) . Quarterly Journal of Medicine . 1981;198:205–212
  31. Duplay D . In: Physicians’ Desk Reference . Montvale, NJ: Thompson PDR; 2004;p. 2000–2003
  32. Low PA , Gilden JL , Freeman GR , et al.   Efficacy of midodrine vs placebo in neurogenic orthostatic hypotension, a randomized, double- blind multicenter study . JAMA . 1997;277:1046–1051
  33. McTavish D , Goa KL . Midodrine (A review of its pharmacological properties and therapeutic use in orthostatic hypotension and secondary hypotensive disorders) . Drugs . 1989;38:757–777
  34. Zachariah PK , Bloedow DC , Moyer TP , et al.   Pharmacodynamics of mididrine, an antihypotensive agent . Clin Pharmacol Ther . 1986;39:586–591
  35. Mathias CJ , Fosbraey P , Da Costa DF . The effect of desmopressin on nocturnal polyuria, overnight weight loss and morning hypotension in patients with autonomic failure . BMJ . 1986;293:353–354
  36. Hoeldtke RD , Streeten DH . Treatment of orthostatic hypotension with erythropoietin . N Engl J Med . 1993;329:611–615
  37. Onrot J , Goldberg MR , Biaggioni I , et al.   Hemodynamic and humeral effects of caffeine in autonomic failure . N Engl J Med . 1985;313:549–554

PII: S1525-8610(05)00628-6

doi: 10.1016/j.jamda.2005.10.011

JAMDA
Volume 7, Issue 3 , Pages 163-167 , March 2006

Article Tools

* Image Usage & Resolution