The effect of a change in antihypertensive treatment on orthostatic hypotension in older adults: A systematic review and meta-analysis

Orthostatic hypotension (OH) is common in older adults with hypertension. Antihypertensive treatment (AHT) prevents cardio- and cerebrovascular events. However, physicians are concerned to cause OH, making them hesitant to initiate or augment AHT in older adults with hypertension. We systematically...

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Bibliographic Details
Published in:Experimental gerontology 2024-08, Vol.193, p.112461-112461, Article 112461
Main Authors: Klop, Marjolein, Maier, Andrea B., Meskers, Carel G.M., Steiner, Julika M., Helsloot, D. Odette, van Wezel, Richard J.A., Claassen, Jurgen A.H.R., de Heus, Rianne A.A.
Format: Article
Language:English
Subjects:
Antihypertensive medication
Blood pressure
Hypertension
Postural hypotension
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Summary:Orthostatic hypotension (OH) is common in older adults with hypertension. Antihypertensive treatment (AHT) prevents cardio- and cerebrovascular events. However, physicians are concerned to cause OH, making them hesitant to initiate or augment AHT in older adults with hypertension. We systematically researched electronic databases for trials with older participants (≥65 years) with hypertension and OH assessment after initiating, discontinuing, or augmenting AHT. Study quality was assessed using the ROBINS-I tool. Meta-analyses on OH prevalence and postural blood pressure (BP) drop were performed. Twenty-five studies (26,695 participants) met inclusion criteria, of which fifteen could be included in the meta-analyses. OH prevalence decreased after AHT initiation or augmentation (risk ratio 0.39 (95 % CI = 0.21–0.72; I2 = 47 %; p 
ISSN:0531-5565
1873-6815
DOI:10.1016/j.exger.2024.112461