Clinical presentation of orthostatic hypotension in the elderly.
Fifty cases of orthostatic hypotension in the elderly are analysed. Three main modes of presentation were identified: (1) falls or mobility problems; (2) mental confusion or dementia; or (3) predominantly cardiac symptoms. Selected case histories are given to illustrate diagnostic difficulties. Medication was responsible for orthostatic hypotension in 66% of patients and striking examples of polypharmacy were encountered. However, 34% of cases were not iatrogenic. Only 14% of patients had overtly postural symptoms. A high index of suspicion is needed to diagnose orthostatic hypotension in the elderly and the condition is often overlooked. The paper provides useful diagnostic clues for clinicians.
Craig
G M
GM
Northampton Health Authority, UK.
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications*; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications* / Q000175:diagnosis; D008297:Male