Orthostatic hypotension in the elderly

Article Abstract:

Orthostatic hypotension is a rapid drop in blood pressure that results from a change in posture. The condition is often seen in the elderly and it may be associated with injuries that result from falling or fainting. It is estimated that the problem may occur in as many as 20 percent of those over 65 years of age and 30 percent of individuals older than 75. A recent study has shown that the condition may be due to an age-related increase in (systolic) blood pressure when lying on one's back: blood pressure drops rapidly when sitting up, and this can result in light-headedness or fainting. When a person assumes an upright position, a large volume of blood is pooled in the legs and internal organs. The amount of blood returning to the heart consequently decreases and there is a temporary decrease in the volume of blood being pumped by the heart. This results in reflexes which adjust the circulatory system to restore pressure and volume. In the elderly the reflexive mechanism may not work as efficiently as in a younger person. With aging the elasticity of the vascular system is gradually lost and this both adds to the elevation of blood pressure and restricts the venous return of blood to the heart, both factors adding to the problem of orthostatic hypotension. Hypotension also increases risk of inadequate flow of blood to the brain (cerebral ischemia), which increases other symptoms. In many cases orthostatic hypotension is considerably exacerbated by the medications which the patient may be receiving for other conditions. Treatment for the problem must include a thorough evaluation of each patient's specific needs and may involve prescribing certain drugs (mineralocorticoids) while discontinuing others.

Aged, Elderly, Evaluation, Causes of, Physiological aspects, Diseases, Blood pressure, Cerebral ischemia, Sleep positions, Blood circulation disorders, Vascular diseases, column, Mineralocorticoids

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Treatment of orthostatic hypotension with erythropoietin

Article Abstract:

Erythropoietin may be an effective treatment for orthostatic hypotension caused by autonomic neuropathies. Orthostatic hypotension is a drop in blood pressure associated with dizziness, fainting and blurred vision upon standing or when standing motionless in a fixed position. An autonomic neuropathy is a disorder that affects the autonomic nervous system. Four of eight patients with orthostatic hypotension had autonomic neuropathies caused by type I diabetes mellitus. Three had autonomic failure and one had sympathotonic orthostatic hypotension. The patients were treated with 50 units of erythropoietin per kilogram of body weight three times per week over a six- to 10-week period. Treatment with erythropoietin increased the patients' systolic and diastolic blood pressure while standing. Six patients experienced less orthostatic dizziness during treatment with erythropoietin. Treatment with erythropoietin increased the patients' average red blood cell volume.

Health aspects, Drug therapy, Erythropoietin

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Case 1-2008: a 45-year-old man with sudden onset of abdominal pain and hypotension

Article Abstract:

The article presents the case study of a 45-year old man with sudden onset of abdominal pain and hypotension and discusses the diagnostic procedure performed.

United States, Arteries, Arterial stenosis, Case study

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