Non-pharmacological management of orthostatic hypotension in the older patient

Autor:	Daniel J Ryan, Chie Wei Fan, Conal J Cunningham
Rok vydání:	2011
Předmět:	medicine.medical_specialty Supine hypertension business.industry Disease Orthostatic vital signs Therapeutic approach Older patients Lifestyle modification Anesthesia medicine Popular opinion Geriatrics and Gerontology Intensive care medicine business Gerontology Non pharmacological
Zdroj:	Reviews in Clinical Gerontology. 22:119-129
ISSN:	1469-9036 0959-2598
DOI:	10.1017/s0959259811000220
Popis:	SummaryOrthostatic hypotension (OH) occurs in up to 30% of community-dwelling older people. Its presence confers a greater risk of incident co-morbid disease and all-cause mortality. As per guidelines, first-line treatment should consist of non-pharmacological therapies. Effective lifestyle modification advice includes the avoidance of rapid postural changes and large meals. Physical counter-manoeuvres, when comprehensively described, effectively abate symptom progression. Patients should drink 1.5 to 2 litres of water daily, though reports suggest only half of older people comply with this regime. Moderate salt consumption is advised, though with caution as supine hypertension often co-exists. Compression hosiery benefits older people and, contrary to popular opinion, is well tolerated. Potential, future therapies include impedance threshold devices. Older patients with OH frequently have co-morbid disease such that a pharmacological approach is ill-advised. They respond well to non-pharmacological therapies and these should form the primary therapeutic approach.
Databáze:	OpenAIRE
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