Fludrocortisone in the treatment of hypotensive disorders in the elderly.
OBJECTIVE
To evaluate tolerance of fludrocortisone in older patients with hypotensive disorders.


METHODS
Prospective case series.


METHODS
Syncope clinic.


METHODS
64 Consecutive patients over 65 years (mean age 80 years) with one or more hypotensive disorders (orthostatic hypotension, vasodepressor carotid sinus syncope, and/or vasodepressor neurocardiogenic syncope.


METHODS
Fludrocortisone in daily doses of 100 micrograms [corrected] (72%), 50 micrograms [corrected] (27%), and 200 micrograms [corrected] (one patient).


METHODS
Adverse events, treatment withdrawal.


RESULTS
During follow up 13 patients died of unrelated causes. Of the remainder 33% discontinued fludrocortisone at a mean of five months. Reasons for discontinuing treatment were hypertension, five; cardiac failure, four; depression, three; oedema, three; and unspecified, two. In those who continued treatment supine systolic and diastolic blood pressure did not differ significantly from baseline (follow up two to 21 months). Hypokalaemia developed in 24% at a mean of eight months; in no case was treatment withdrawn because of hypokalaemia.


CONCLUSIONS
Fludrocortisone, even in low doses, is poorly tolerated in the long term in older patients with hypotensive disorders.
Hussain
R M
RM
Cardiovascular Investigation Unit, Royal victoria Infirmary, Newcastle upon Tyne.
McIntosh
S J
SJ
Lawson
J
J
Kenny
R A
RA
D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000139:chemically induced; D004334:Drug Administration Schedule; D004487:Edema / Q000139:chemically induced; D005069:Evaluation Studies as Topic; D005438:Fludrocortisone / Q000009:adverse effects / Q000627:therapeutic use*; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007008:Hypokalemia / Q000139:chemically induced; D007022:Hypotension / Q000188:drug therapy*; D008901:Mineralocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors
D008901:Mineralocorticoids; D005438:Fludrocortisone