Key result
Tailored management of concurrent HTN and orthostatic hypotension in frail older adults is required given fall risks.
Why the study?
Hypertension and orthostatic hypotension frequently coexist in older adults, creating a clinical management challenge, yet current clinical guidelines offer limited guidance.
How should hypertension and orthostatic hypotension be managed in frail older adults?
How should hypertension and orthostatic hypotension be managed in frail older adults?
This review provides expert-opinion-based recommendations to address the clinical challenge of managing coexisting hypertension and orthostatic hypotension in frail older adults, an area with limited guideline direction.
Tailored BP management is warranted in frail older adults with coexisting hypertension and orthostatic hypotension; leaves open need for prospective trials to guide recommendations.
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.
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Wiersinga et al. (2024) conducted a review in Hypertension and orthostatic hypotension. Management of coexisting hypertension and orthostatic hypotension in frail older adults requires tailored approaches due to limited clinical guideline support and increased fall risks.
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