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.
Northampton Health Authority, UK.
G M
GM
Craig
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