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Orthostatic Hypotension and Drugs: Drug-Induced Orthostatic Hypotension

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Orthostatic Hypotension in Older Adults

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Abstract

Drug-Induced Orthostatic Hypotension (DOH) is considered as one of seconder Orthostatic Hypotension (OH) and it usually leads to OH symptoms such as light-headedness, syncope, falls, injury in the elderly. DOH originates from dysfunction of autonomic tone that regulates blood pressure and it can lead to OH or trigger easily OH by medications. As a clinically significant finding DOH or OH, is defined as a transient blood pressure decrease (≥40 mmHg systolic blood pressure and/or ≥20 mmHg diastolic blood pressure) within 15 s of standing. Symptoms of patients suffering from OH or DOH are light-headedness, dizziness, nausea, weakness or blurred vision during in standing position. OH, is very common, affecting one in five community-dwelling older people, the prevalence ranges from 5% to 30%, increases with age and mostly seen in patients ≥65 years old. Especially, older age is the most important risk factor for DOH, the same as for alpha-adrenergic receptor antagonists, calcium channel blockers, diuretics, angiotensin converting enzyme inhibitors, antipsychotics, β-adrenergic receptor blockers, tricyclic antidepressants, anti-Parkinsonian drugs, and polypharmacy. DOH hypotension is a frequent finding and issue in geriatric patients and removal of the triggering factors should be the first action.

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Abbreviations

ACE:

Angiotensin Converting Enzyme

CCBs:

Calcium Channel blockers

DOH:

Drug-Induced Orthostatic Hypotension

L-DOPA:

Levodopa

OH:

Orthostatic Hypotension

PD:

Parkinson’s Disease

TCAs:

Tricyclic Antidepressants

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Authors and Affiliations

  1. Department of Pharmacology, Faculty of Pharmacy, Yeditepe University of Medical Sciences, İstanbul, Turkey

    Suha Beril Kadioglu & Turgay Celik

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  1. Suha Beril Kadioglu
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  2. Turgay Celik
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Correspondence to Turgay Celik .

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Editors and Affiliations

  1. Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Ahmet Turan Isik

  2. Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Pinar Soysal

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Kadioglu, S.B., Celik, T. (2021). Orthostatic Hypotension and Drugs: Drug-Induced Orthostatic Hypotension. In: Isik, A.T., Soysal, P. (eds) Orthostatic Hypotension in Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-030-62493-4_6

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  • DOI: https://doi.org/10.1007/978-3-030-62493-4_6

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