Orthostatic hypotension and associated conditions in geriatric inpatients

Screening of orthostatic hypotension (OH) was performed in 285 patients aged 75 years. Current drugs, reasons for admission, geriatric syndromes, and confounding medical conditions were collected. Patients with OH (n=116, 41%) as compared to those without OH (n=169) more frequently (P<0.01) presented falls in the last 6 months (62 vs. 40%, P<0.001), a fall as the reason for the current admission (49 vs. 26%, P<0.001), feeling of fainting (20 vs. 6%, P=0.002), syncope (29 vs. 4%, P<0.001) or functional decline (71 vs. 47%, P=0.012). No difference was observed between the two groups in terms of age (85 +/- 5 vs. 84 +/- 4 years), gender (59 vs. 50% female), common geriatric conditions (e.g. malnutrition 46 vs. 58%, dementia 22 vs. 26%), comorbidity or confounding conditions (dehydration 28 vs. 30%, sepsis 2 vs. 6%). No difference was detected in the use of drugs with psychotropic cardiovascular or diuretic effect, or in their associations. Orthostatic hypotension is frequent upon hospital admission and should be screened, particularly in geriatric fallers. This absence of relation between OH and drugs use suggests that non-pharmacological interventions should be first attempted in older inpatients with OH before deciding to reduce or withdraw useful drugs.