Orthostatic hypotension with no neurogenic trigger in the elderly

Introduction. Orthostatic hypotension (OH) symptoms ni-e the most frequent reason Sor patients to undergo ail automatic examination. The incidence of these symptoms is greater in two groups: young people with neurally mediated syncope, aid adults older than 60 years, all who have normal results ill the EKG and EEG teal. The baroreflex afferences induce a continuous blood pressure adjustment through the heart rate variation. There are functional changes with aging which induce tills baroreflex sensitivity and therefore the accommodation to the haemodynamic requirements is frequently impaired. A number, of no neurogenic triggers can be implicated ir the development of OH symptoms such as electrolytic disorders, arrhythmia with low stroke volume and drugs side effects. Material and methods. To study the influence of these factors in the elderly suffering from OH, rue reviewed patients older than 60 years sent to our laboratory during the last three years. in 40 out of 207 eases we found the existence of some of the above mentioned factors as possible trigger of the symptoms, since no automatic abnormality, was present. After arrhythmia correction, ill two eases, and the pharmacologic agent suppression, ill four more patients, symptoms disappeared and Ira OH was found in a second tilting test. OH is a frequent problem in the elderly and requires a careful review of the numerous causes that could contribute to develop the symptoms. Conclusions. To take the proper therapeutic decision, a long term monitoring seems to be necessary for the main parameters: blood pressure and EKG.