The efficacy of nonpharmacologic intervention for orthostatic hypotension associated with aging.

Neurology
Julia L Newton, James Frith

Abstract

To determine the efficacy and safety of nonpharmacologic interventions for orthostatic hypotension (OH) secondary to aging. A total of 150 orthostatic challenges were performed in 25 older people (age 60-92 years) to determine cardiovascular responses to bolus water drinking, compression stockings, abdominal compression, and physical countermaneuvers. Primary outcome was response rate as assessed by proportion of participants whose systolic blood pressure (SBP) drop improved by ≥10 mm Hg. The response rate to bolus water drinking was 56% (95% confidence interval [CI] 36.7-74.2), with standing SBP increasing by 12 mm Hg (95% CI 4-20). Physical countermaneuvers were efficacious in 44% (95% CI 25.8-63.3) but had little effect on standing SBP (+7.5 mm Hg [95% CI -1 to 16]). Abdominal compression was efficacious in 52% (95% CI 32.9-70.7) and improved standing SBP (+10 mm Hg [95% CI 2-18]). Compression stockings were the least efficacious therapy (32% [95% CI 16.1-51.4]) and had little effect on standing SBP (+6 mm Hg [95% CI -1, 13]). No intervention improved symptoms during standing. There were no adverse events. Bolus water drinking should become the standard first-line nonpharmacologic intervention, whereas compression stockings ...Continue Reading

References

Mar 17, 2001·Statistics in Medicine·R P A'Hern
Aug 26, 2006·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·H LahrmannM Tassinari
Apr 23, 2008·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Phillip A Low
Mar 25, 2011·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Roy FreemanJ Gert van Dijk
Nov 3, 2011·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Horacio KaufmannRoy Freeman
Apr 5, 2014·Journal of Internal Medicine·W WielingJ R Halliwill
Aug 26, 2014·Age and Ageing·James FrithJulia L Newton
Dec 3, 2014·Archives of Physical Medicine and Rehabilitation·Patricia Branco MillsAndrei Krassioukov
Dec 5, 2014·PloS One·Richard M DoddsAvan Aihie Sayer

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Citations

Mar 23, 2019·The Journal of Clinical Hypertension·Nikolaos MagkasDimitrios Tousoulis
Feb 23, 2019·Current Treatment Options in Neurology·Christopher D StephenJeremy D Schmahmann
Jul 11, 2019·Current Treatment Options in Neurology·Louise M Allan
Jul 26, 2019·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·M ZimmermannK Brockmann
Aug 29, 2019·Neurology and Therapy·Jeremy K Cutsforth-Gregory, Phillip A Low
Nov 12, 2018·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Mitchell G Miglis, Srikanth Muppidi
Jul 28, 2020·Journal of Parkinson's Disease·Alessandra FanciulliGregor K Wenning
Jan 31, 2020·Continuum : Lifelong Learning in Neurology·Jose-Alberto Palma, Horacio Kaufmann
Nov 1, 2020·Drug and Therapeutics Bulletin·Jake Ryan Gibbon, James Frith
Mar 25, 2020·The American Journal of Cardiology·Brian Olshansky, James Muldowney
May 22, 2019·Journal of the American Medical Directors Association·Selvarani SubbarayanRoy L Soiza
Sep 3, 2021·Heart Failure Reviews·Morris M KimAhmad Masri

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ISRCTN15084870

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