title: [Orthostatic hypotension: marker of severity and management of antihypertensive treatment].
abstract: Orthostatic Hypotension (OH) is an independent predictor of cardiovascular disease and of all-cause mortality. It is a marker of poor prognosis in older and middle-aged patients. It should be primarily sought, at diagnosis of hypertension, at therapeutic modification, and when suspected by symptoms. One must make therapeutic decisions in older patients, based on measured blood pressure in standing position. Before blaming the antihypertensive treatment, one must search for other contexts favoring orthostatic hypotension. The antihypertensive treatment in older patients should: be initiated with low dosages and subsequent dose titration, be associated to lifestyle changes, not be associated to medications that have the potential to induce Orthostatic Hypotension, include a clear information about Orthostatic Hypotension (recognition, preventive measures…).
authors.affiliation: Université Paris-Descartes, Hôtel-Dieu, Paris, Assistance Publique-hôpitaux de Paris, unité HTA, prévention et thérapeutique cardiovasculaires, centre de diagnostic et de thérapeutique, 75004 Paris, France.
authors.forename: Goel
authors.initials: G
authors.lastname: Fenech
authors.forename: Michel
authors.initials: M
authors.lastname: Safar
authors.forename: Jacques
authors.initials: J
authors.lastname: Blacher
mesh_terms: D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D002423:Cause of Death; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007024:Hypotension, Orthostatic / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D008875:Middle Aged; D010353:Patient Education as Topic; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000959:Antihypertensive Agents