This book provides a comprehensive and practical guide to
orthostatic hypotension (OH) for doctors and nurses involved in the
care of older adults, together with a state-of-the-art update on
OH, covering its epidemiology, pathophysiology, assessment,
diagnosis, causes, prevention, management, and relevance for
geriatric practice. In addition, it addresses mechanisms of
orthostatic tolerance and other orthostasis related conditions, as
well as drugs, comorbidities and geriatric syndromes related to OH.
The homeostatic ability to maintain blood pressure while standing
requires an adequate blood volume and the integrity of the nervous
system, heart, blood vessels and muscle pump. However, in older
adults, some age-related factors can contribute to the development
of OH. For example, decreased baroreflex sensitivity, -1-adrenergic
vasoconstrictor response to sympathetic stimuli, parasympathetic
activity, renal salt and water conservation, increased vascular
stiffness and decreased ventricular diastolic filling, as well as
concentrated capacities of the kidney may be associated with
changes in postural blood pressure. It has also been shown that OH
is associated with falls, cardiac events, heart failure, stroke,
reduced quality of life, and increased risk of overall mortality in
these patients. "Orthostatic Hypotension in Older Adults" will be
of considerable interest to all professionals working in the fields
of geriatrics, geriatric psychiatry, neurology, internal medicine,
cardiology, and emergency medicine, or working with older people in
hospitals or in their community.
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