Key result
Non-pharmacological approaches are the first-line treatment for orthostatic hypotension, while pharmacological therapies like fludrocortisone and midodrine are reserved for persistent symptoms.
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This review outlines a stepwise approach to managing orthostatic hypotension, emphasizing lifestyle modifications and physical maneuvers before initiating pharmacotherapy.
In the older population, especially the hospitalized patients who are prone to dehydration and hypovolemia, orthostatic hypotension (OH) presents as a debilitating disease. How different pharmacological and non-pharmacological interventions affect the incapacitating symptoms (falls and episodes of syncope), morbidity, and mortality related to OH has become a topic of debate. OH can predispose to ischemic heart disease (IHD). A non-pharmacological approach consisting of mobilization, early lifestyle changes, and therapeutic maneuvers is the first choice in the management of these patients. Individuals with persistent symptoms require pharmaceutical therapy to increase blood volume and peripheral vascular resistance. This article summarizes the management of OH that is vital to cope with the needs of the growing geriatric populations.
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Asad et al. (2018) conducted a review in Orthostatic Hypotension. Pharmacological and non-pharmacological interventions was evaluated. Non-pharmacological approaches are the first-line treatment for orthostatic hypotension, while pharmacological therapies like fludrocortisone and midodrine are reserved for persistent symptoms.
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