Of those, 48 were diagnosed with delayed orthostatic hypotension, 42 had orthostatic hypotension and 75 did not have either condition. The rate of death over 10 years was 29 percent for people with delayed orthostatic hypotension, 64 percent for those with orthostatic hypotension the more serious form of the disease and 9 percent in people without either condition.
The death rate over 10 years for those with the delayed condition who progressed to orthostatic hypotension was 50 percent. People with delayed orthostatic hypotension who also had diabetes at the beginning of the study were more likely to develop the full condition than those without diabetes.
Many of the people with the delayed condition that did not develop the full condition were taking medications that may have affected their blood pressure, such as diuretics, antidepressants and high blood pressure drugs.
Gibbons said limitations of the study included that it was a retrospective review of data collected earlier and that participants were all referred to a specialized center for tests of the autonomic nervous system and may not reflect the overall community. To learn more about orthostatic hypotension, please visit www. Doctors may give fludrocortisone , a drug that helps the body retain salt and water and thus prevent blood pressure from dropping when a person stands.
However, this drug may cause high blood pressure when people are lying down, heart failure, and low levels of potassium in the blood. Sometimes doctors combine propranolol or another beta-blocker with fludrocortisone. Midodrine is a drug that narrows both arteries and veins, helping prevent blood pooling.
Side effects include tingling or numbness and itching. This drug is not recommended for people with coronary artery or peripheral arterial disease. Other drugs such as nonsteroidal anti-inflammatory drugs NSAIDs , droxidopa , pyridostigmine and octreotide may help in some cases.
It is more common among people with coexisting disorders, especially high blood pressure, and among residents of long-term care facilities. Many falls may result from dizziness when standing. Older people should avoid prolonged standing. The increased incidence in older people is due to decreases in the responsiveness of the receptors that manage blood pressure plus increases in arterial wall stiffness, which make it more difficult for arteries to move more blood to increase blood pressure.
Decreases in receptor responsiveness delay the normal heart and blood vessel responses to standing. Paradoxically, high blood pressure, which is more common among older people, may contribute to poor receptor sensitivity, increasing vulnerability to dizziness when standing. Dizziness or light-headedness when standing typically involves a decrease in body fluid volume or autonomic nervous system dysfunction. Aging often causes some degree of autonomic nervous system dysfunction, but doctors examine all affected people to ensure that no nervous system disorders are present.
Treatment involves physical measures to reduce venous pooling, regular exercise, increased salt intake, and sometimes fludrocortisone or midodrine. Merck and Co. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge.
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