PT  - JOURNAL ARTICLE
AU  - Melanie Dani
AU  - Andreas Dirksen
AU  - Patricia Taraborrelli
AU  - Dimitrios Panagopolous
AU  - Miriam Torocastro
AU  - Richard Sutton
AU  - Phang Boon Lim
TI  - Orthostatic hypotension in older people: considerations, diagnosis and management
AID  - 10.7861/clinmed.2020-1044
DP  - 2021 May 01
TA  - Clinical Medicine
PG  - e275--e282
VI  - 21
IP  - 3
4099  - http://www.rcpjournals.org/content/21/3/e275.short
4100  - http://www.rcpjournals.org/content/21/3/e275.full
SO  - Clin Med2021 May 01; 21
AB  - Orthostatic hypotension (OH) is very common in older people and is encountered daily in emergency departments and medical admissions units. It is associated with a higher risk of falls, fractures, dementia and death, so prompt recognition and treatment are essential. In this review article, we describe the physiology of standing (orthostasis) and the pathophysiology of orthostatic hypotension. We focus particularly on aspects pertinent to older people. We review the evidence and consensus management guidelines for all aspects of management. We also tackle the challenge of concomitant orthostatic hypotension and supine hypertension, providing a treatment overview as well as practical suggestions for management. In summary, orthostatic hypotension (and associated supine hypertension) are common, dangerous and disabling, but adherence to simple structures management strategies can result in major improvements.