Background: Orthostatic hypotension, postprandial hypotension, and falls are considered to be adverse drug reactions of antihypertensive therapy in older people with comorbidities. Concerns regarding these adverse events may limit the use of antihypertensive agents in this group of people.
Objective: The aim of this study was to determine the relationship between antihypertensive therapy in octo- and nonagenarians and the risk for orthostatic hypotension, postprandial hypotension, and falls.
Methods: This was a case-control study of octo- and nonagenarians living in residential care facilities who were receiving antihypertensive therapy and a control group who were not receiving antihypertensive therapy.
Results: A total of 119 patients, 77 who were receiving regular antihypertensive therapy and 42 who were not taking any antihypertensive agents, were enrolled in the study. The prevalence of antihypertensive use, orthostatic hypotension, postprandial hypotension, and falls was high (65%, 29%, 57%, and 45%, respectively). There were no associations between antihypertensive therapy and orthostatic hypotension, postprandial hypotension, and falls. When individual classes of antihypertensive agents were examined, the only observed association was a negative association (ie, a protective effect) between potassium-sparing diuretics and falls (odds ratio, 0.2; 95% CI, 0.04-1.0).
Conclusion: Antihypertensive therapy was not associated with an increased risk for orthostatic hypotension, postprandial hypotension, or falls in this case-control study of octo- and nonagenarians living in residential care facilities.
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http://dx.doi.org/10.1016/S0011-393X(03)00023-7 | DOI Listing |
BMC Med
January 2025
Department of Cardiology, The Third Xiangya Hospital of Central South University, Yuelu District, 138 Tongzipo Road, Changsha, 410013, Hunan, China.
Background: Guidelines recognized dual combination in initial antihypertensive therapy. Studies found that low-dose quadruple combination were superior to monotherapy. However, whether low-dose quadruple therapy is better than dual combination is unknown.
View Article and Find Full Text PDFArq Bras Oftalmol
January 2025
Discipline of Health Management and Economics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Purpose: To evaluate the economic impact of the following initial treatment scenarios for glaucoma on the Brazilian Public Health System (SUS): (1) traditional continuous instillation of hypotensive eye drops and (2) single session of selective laser trabeculoplasty.
Methods: Economic impact was analyzed in three scenarios, from the least to the most conservative, for a hypothetical cohort of 5,000 individuals with open-angle glaucoma. Thereafter, projections were made on the basis of a glaucoma prevalence of 3% in the 2021 Brazilian population size.
Cutis
December 2024
Drs. Lu, Du, Zhao, and Fan and Lingbo Bi, Chaofan Wang, and Yunbu Ding are from the Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, China. Yige Fan is from the Mayo Clinic, Rochester, Minnesota.
PLoS One
January 2025
Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
Recent studies suggested intrathecal vasodilator administration as a therapy to mitigate post-ischemic cerebral hypoperfusion following cardiac arrest. We examined the effects of two commonly used intrathecal vasodilators, sodium nitroprusside (SNP) and nicardipine, on cerebral pial microcirculation, cortical tissue oxygen tension (PctO2), and electrocortical activity in the early post-resuscitation period using a porcine model of cardiac arrest. Thirty pigs were resuscitated after 14 min of untreated cardiac arrest.
View Article and Find Full Text PDFJAMA Cardiol
January 2025
Ifakara Health Institute, Ifakara Branch, Ifakara, United Republic of Tanzania.
Importance: Hypertension is the primary cardiovascular risk factor in Africa. Recently revised World Health Organization guidelines recommend starting antihypertensive dual therapy; clinical efficacy and tolerability of low-dose triple combination remain unclear.
Objectives: To compare the effect of 3 treatment strategies on blood pressure control among persons with untreated hypertension in Africa.
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