Terazosin was associated with the highest risk signal for drug-induced orthostatic hypotension, demonstrating a reporting odds ratio of 153.96.
Observational (n=15,480)
Which drugs are most significantly associated with an increased risk of orthostatic hypotension in adverse event reporting databases?
A disproportionality analysis of the FAERS database identified 33 drugs, predominantly cardiovascular and nervous system agents, significantly associated with orthostatic hypotension, highlighting the need for clinical vigilance.
Odds Ratio: 153.96 (95% CI 124.57–190.28)
Orthostatic hypotension (OH) is not uncommon among the elderly persons and significantly contributes to issues including falls, syncope, and increased mortality risk. While classic OH has long been recognized, two clinically important subtypes, initial OH and delayed OH are frequently underdiagnosed. Initial OH is characterized by a rapid, significant decrease in blood pressure (exceeding 40/20 mmHg systolic blood pressure/diastolic blood pressure) within the initial 15 seconds of standing, resulting from a transient discord between cardiac output and vascular resistance. Delayed OH manifests gradually, typically after over three minutes of standing, and is associated with autonomic neuropathy and neurodegenerative disorders. In the elderly, both categories are exacerbated by age-related changes, polypharmacy, and morbidities. This article reviews definitions, prevalence, etiologies, diagnostic methods, impacts, and contemporary management options of initial and delayed OH, aiming to improve clinical recognition and care in this population.
Jeeyoung Oh (Mon,) conducted a observational in Orthostatic hypotension (n=15,480). Terazosin (and other top 50 suspected drugs) vs. Other drugs in the database was evaluated on Reporting odds ratio (ROR) for orthostatic hypotension (ROR 153.96, 95% CI 124.57-190.28). Terazosin was associated with the highest risk signal for drug-induced orthostatic hypotension, demonstrating a reporting odds ratio of 153.96.