Non-pharmacological therapies should form the primary therapeutic approach for orthostatic hypotension, which affects up to 30% of community-dwelling older people.
Do non-pharmacological therapies improve symptoms in older patients with orthostatic hypotension?
Non-pharmacological therapies should form the primary therapeutic approach for orthostatic hypotension in older patients, especially given the frequent presence of co-morbidities that make pharmacological approaches ill-advised.
Summary Orthostatic hypotension (OH) occurs in up to 30% of community-dwelling older people. Its presence confers a greater risk of incident co-morbid disease and all-cause mortality. As per guidelines, first-line treatment should consist of non-pharmacological therapies. Effective lifestyle modification advice includes the avoidance of rapid postural changes and large meals. Physical counter-manoeuvres, when comprehensively described, effectively abate symptom progression. Patients should drink 1.5 to 2 litres of water daily, though reports suggest only half of older people comply with this regime. Moderate salt consumption is advised, though with caution as supine hypertension often co-exists. Compression hosiery benefits older people and, contrary to popular opinion, is well tolerated. Potential, future therapies include impedance threshold devices. Older patients with OH frequently have co-morbid disease such that a pharmacological approach is ill-advised. They respond well to non-pharmacological therapies and these should form the primary therapeutic approach.
Ryan et al. (Tue,) conducted a review in Orthostatic hypotension. Non-pharmacological therapies was evaluated. Non-pharmacological therapies should form the primary therapeutic approach for orthostatic hypotension, which affects up to 30% of community-dwelling older people.