title: [Orthostatic hypotension: implications for the treatment of cardiovascular diseases].
abstract: Several cardiovascular drugs may induce or worsen orthostatic hypotension especially in patients treated for hypertension, coronary artery disease and heart failure. Orthostatic hypotension is more frequent in polymedicated elderly patients with co-morbidities (prevalence 23%). In hypertensive elderly patients, the combination of three antihypertensive agents including a beta-blocker induces more frequently orthostatic hypotension. Supplementation in water and especially salt is generally not recommended in case of hypertension and heart failure. Education of patient to preventive counter-pressure maneuvers and muscle training of the lower limbs must be part of treatment. Midodrine causes supine hypertension in almost 25% of patients precluding to take this medication at the end of the afternoon. In severe heart failure, midodrine seems to be helpful to optimize drug treatment in patients suffering from hypotension.
authors: CHRU de Brest, hôpital de La Cavale Blanche, département de cardiologie, 29609 Brest cedex, France. jacques.mansourati@chu-brest.fr
authors: Jacques
authors: J
authors: Mansourati
mesh_terms: D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D000075202:Contraindications; D060766:Drinking Water / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000009:adverse effects; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D007024:Hypotension, Orthostatic / Q000139:chemically induced* / Q000517:prevention & control / Q000628:therapy*; D007049:Iatrogenic Disease / Q000517:prevention & control; D008879:Midodrine / Q000627:therapeutic use; D010353:Patient Education as Topic; D019338:Polypharmacy; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D002317:Cardiovascular Agents; D060766:Drinking Water; D014662:Vasoconstrictor Agents; D008879:Midodrine