A Comparative Study on Orthostatic Hypotension in Elderly Hypertensives and Non Hypertensives.

Gopinath, K G (2006) A Comparative Study on Orthostatic Hypotension in Elderly Hypertensives and Non Hypertensives. Masters thesis, Madras Medical College, Chennai.

[img]
Preview
Text
2016001gopinath.pdf

Download (360kB) | Preview

Abstract

Orthostatic hypotension is a common and important clinical disorder in the elderly population. The pathogenesis is multi factorial but is probably often due to changes in the autonomic nervous system, as well as to age-related changes in the cardiovascular and endocrine systems. Orthostatic hypotension can be seen as a prototypical clinical disorder of the elderly (1, 6). In addition, the presence of multiple diseases and medications, especially antihypertensives (2, 5) are common contributing factors. Standardized measurement of postural blood pressure and recording of heart rate and assessment of associated symptoms are essential for the clinical diagnosis. Usually elimination of offending medications and treatment of contributing medical disorders are adequate. It reflects impaired homeostasis; its etiology is multi factorial and due to the effects of both age and disease; it is clinically protean. It can result in falls, injury, and progressive decline if not recognized and treated early. Many studies have proved that Orthostatic hypotension is more prevalent among the elderly population, and more so among the elderly hypertensives. Symptoms, as mentioned above can lead to drug non- compliance as well as a reduced quality of life. High blood pressure, once believed to represent a normal and progressive component of the aging process, is now recognized as a manifestation of structural and physiologic abnormalities of aortic function. Elevated systolic blood pressure and increased pulse pressure unquestionably increase the risk of both fatal and nonfatal cardiovascular events, including stroke, myocardial infarction, and heart failure. Isolated systolic hypertension, defined as a systolic blood pressure > 140 mm Hg with a diastolic blood pressure < 90 mm Hg, affects most individuals aged 60 years and older. Several clinical trials have clearly demonstrated that treatment of hypertension significantly reduces the cardiovascular event rate. However, controversy continues as to the choice of antihypertensive agents and combinations of agents. It is both appropriate and necessary to treat elderly hypertensives aggressively to the same target blood pressures identified for younger patients. It is also appropriate to initiate treatment with lower doses of antihypertensive agents and to bring the pressure down more slowly, monitoring for orthostatic hypotension, impaired cognition, and electrolyte abnormalities. 1) Orthostatic hypotension is a common clinical disorder in the elderly. There is no sex difference in the prevalence of orthostatic hypotension. 2) The prevalence of Orthostatic hypotension is more among hypertensives than non – hypertensives. 3) There is no significant relation between orthostatic hypotension and the symptoms of orthostatic hypotension. 4) Orthostatic hypotension is not related to either the type or number of drugs used in this study. 5) Development of Orthostatic hypotension has no relation to control of hypertension.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Orthostatic Hypotension; Hypertensives; Non Hypertensives; Elderly ; A Comparative Study
Subjects: MEDICAL > Geriatrics
Depositing User: Kambaraman B
Date Deposited: 21 Jun 2017 07:58
Last Modified: 21 Jun 2017 07:58
URI: http://repository-tnmgrmu.ac.in/id/eprint/164

Actions (login required)

View Item View Item