[An elderly case of hypertension with persistent orthostatic hypotension].
The authors report the successful control of labile hypertension associated with orthostatic hypotension in a 75-year-old male patient, by means of L-DOPS, a synthetic precursor of norepinephrine in combination with antihypertensive drugs. He had been known to be hypertensive for 15 years and developed a persistent floating sensation 2 years age. Despite good control of hypertension after admission, orthostatic hypotension was still observed. Passive tilt produced a blood pressure reduction of 60/20 mmHg. Spectral analysis of heart rate variability showed a disturbance in the activation of the sympathetic nervous system. Treatment with L-DOPS attenuated the blood pressure reduction in response to passive tilt (35/12 mmHg) and improved the sympathetic response. Because of an increase in blood pressure by L-DOPS, addition of either a calcium channel blocker or an angiotensin-converting enzyme inhibitor was necessary. These combinations of treatment successfully controlled blood pressure as well as orthostatic hypotension.
Nakata
Y
Y
Department of Geriatric Medicine, Osaka University Medical School.
Otsuka
A
A
Oishi
M
M
Moriguchi
A
A
Nagano
M
M
Inoue
T
T
Mikami
H
H
Sakaguchi
K
K
Ogihara
T
T
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D015103:Droxidopa / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007024:Hypotension, Orthostatic / Q000150:complications* / Q000188:drug therapy; D008297:Male
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D015103:Droxidopa