title: Fludrocortisone in the treatment of hypotensive disorders in the elderly.
abstract: 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 Hypokalaemia developed in 24% at a mean of eight months; in no case was treatment withdrawn because of hypokalaemia.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.
authors.affiliation: Cardiovascular Investigation Unit, Royal victoria Infirmary, Newcastle upon Tyne.
authors.forename: R M
authors.initials: RM
authors.lastname: Hussain
authors.forename: S J
authors.initials: SJ
authors.lastname: McIntosh
authors.forename: J
authors.initials: J
authors.lastname: Lawson
authors.forename: R A
authors.initials: RA
authors.lastname: Kenny
mesh_terms: 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
chemical_list: D008901:Mineralocorticoids; D005438:Fludrocortisone