Hypertension and orthostatic hypotension in the elderly: a challenging balance
Summary: Hypertension and orthostatic hypotension (OH) frequently coexist in the older population, both stemming from impaired blood pressure (BP) regulation. Managing hypertension in patients with OH presents a significant clinical challenge, particularly in frail older adults who are also prone to...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | The Lancet Regional Health. Europe |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666776224003235 |
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| author | Julia Wiersinga Sofie Jansen Mike J.L. Peters Hanneke F.M. Rhodius-Meester Marijke C. Trappenburg Jurgen A.H.R. Claassen Majon Muller |
| author_facet | Julia Wiersinga Sofie Jansen Mike J.L. Peters Hanneke F.M. Rhodius-Meester Marijke C. Trappenburg Jurgen A.H.R. Claassen Majon Muller |
| author_sort | Julia Wiersinga |
| collection | DOAJ |
| description | Summary: Hypertension and orthostatic hypotension (OH) frequently coexist in the older population, both stemming from impaired blood pressure (BP) regulation. Managing hypertension in patients with OH presents a significant clinical challenge, particularly in frail older adults who are also prone to falls. Hypertension treatment is often suboptimal in this population due to concerns over the potential increased risk of falls associated with treatment. However, current clinical guidelines provide limited guidance on managing this complex issue. This review explores the pathophysiology of hypertension and OH, reviews existing guidelines, and examines the evidence surrounding hypertension management in patients with OH. Additionally, we provide an overview of research focused on frail older adults and offer expert-opinion-based recommendations for the management of hypertension and OH in routine clinical practice. |
| format | Article |
| id | doaj-art-2f08c022d1034a1880ecead948fd96f6 |
| institution | OA Journals |
| issn | 2666-7762 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Europe |
| spelling | doaj-art-2f08c022d1034a1880ecead948fd96f62025-08-20T02:35:56ZengElsevierThe Lancet Regional Health. Europe2666-77622025-01-014810115410.1016/j.lanepe.2024.101154Hypertension and orthostatic hypotension in the elderly: a challenging balanceJulia Wiersinga0Sofie Jansen1Mike J.L. Peters2Hanneke F.M. Rhodius-Meester3Marijke C. Trappenburg4Jurgen A.H.R. Claassen5Majon Muller6Department of Internal Medicine, Section Geriatrics, Amsterdam UMC, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Atherosclerosis & Ischemic Syndromes, Amsterdam, the Netherlands; Corresponding author. Amsterdam UMC, Location VUmc, Internal Medicine and Geriatrics, Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.Department of Internal Medicine, Section Geriatrics, Amsterdam UMC, Boelelaan 1117, Amsterdam, the NetherlandsDepartment of Internal Medicine Section Geriatrics, UMC Utrecht, University of Utrecht, Utrecht, the NetherlandsAlzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands; Department of Geriatric Medicine, Oslo University Hospital, Ullevål, Oslo, NorwayDepartment of Internal Medicine, Amstelland Hospital, Amstelveen, the NetherlandsRadboud University Medical Center, Departments of Geriatrics, Radboud Research Institute for Medical Innovation and Donders Institute, Nijmegen, the Netherlands; Department of Cardiovascular Sciences, University of Leicester, UKDepartment of Internal Medicine, Section Geriatrics, Amsterdam UMC, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Atherosclerosis & Ischemic Syndromes, Amsterdam, the NetherlandsSummary: Hypertension and orthostatic hypotension (OH) frequently coexist in the older population, both stemming from impaired blood pressure (BP) regulation. Managing hypertension in patients with OH presents a significant clinical challenge, particularly in frail older adults who are also prone to falls. Hypertension treatment is often suboptimal in this population due to concerns over the potential increased risk of falls associated with treatment. However, current clinical guidelines provide limited guidance on managing this complex issue. This review explores the pathophysiology of hypertension and OH, reviews existing guidelines, and examines the evidence surrounding hypertension management in patients with OH. Additionally, we provide an overview of research focused on frail older adults and offer expert-opinion-based recommendations for the management of hypertension and OH in routine clinical practice.http://www.sciencedirect.com/science/article/pii/S2666776224003235HypertensionOrthostatic hypotensionOlder patients |
| spellingShingle | Julia Wiersinga Sofie Jansen Mike J.L. Peters Hanneke F.M. Rhodius-Meester Marijke C. Trappenburg Jurgen A.H.R. Claassen Majon Muller Hypertension and orthostatic hypotension in the elderly: a challenging balance The Lancet Regional Health. Europe Hypertension Orthostatic hypotension Older patients |
| title | Hypertension and orthostatic hypotension in the elderly: a challenging balance |
| title_full | Hypertension and orthostatic hypotension in the elderly: a challenging balance |
| title_fullStr | Hypertension and orthostatic hypotension in the elderly: a challenging balance |
| title_full_unstemmed | Hypertension and orthostatic hypotension in the elderly: a challenging balance |
| title_short | Hypertension and orthostatic hypotension in the elderly: a challenging balance |
| title_sort | hypertension and orthostatic hypotension in the elderly a challenging balance |
| topic | Hypertension Orthostatic hypotension Older patients |
| url | http://www.sciencedirect.com/science/article/pii/S2666776224003235 |
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