DRUG-INDUCED ORTHOSTATIC HYPOTENSION IN THE ELDERLY

The prevalence of orthostatic hypotension in the elderly is reported t o be 5 to 33%. This high prevalence contributes to the risk of syncope and falls in old age. Drugs are a major cause of postural hypotension . Changes in pharmacokinetics and pharmacodynamics occur with aging in relation to many drugs, resulting in delayed elimination and increase d bioavailability. Therefore, drugs with an antihypertensive action (d iuretics, calcium antagonists, beta-blockers, ACE inhibitors, alpha(1) -blockers, and centrally acting antihypertensives) have a more pronoun ced effect in the elderly, Nitrates, antiparkinsonian drugs, antidepre ssants and antipsychotics all cause hypotension as a known adverse eff ect. When assessing orthostatic hypotension in the elderly, drug treat ment should always be reviewed, Whenever possible, antihypertensive dr ugs should be discontinued, and the dosages of essential drugs should be reduced.