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Alcohol and psychotropic drugs: risk factors for orthostatic hypotension in elderly fallers

Journal of Human Hypertension volume 31, pages 299–304 (2017)Cite this article

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Abstract

We assess orthostatic hypotension (OH) prevalence in elderly fallers and determine OH-associated risk factors in this patient population. A monocentric prospective study at Lille University Hospital Falls Clinic included 833 consecutive patients who had fallen or were at high risk of falls and who were assessed for the presence of OH. Among 833 patients aged 80.4±7.4 years, OH was found in 199 subjects (23.9% of cases). Multivariate analysis showed that selective serotonin reuptake inhibitors (odds ratio (OR) 2.42, 95% confidence interval (CI): 1.56–3.75), serotonin-norepinephrine reuptake inhibitors (OR 5.37, 95% CI: 1.93–14.97), Parkinsonian syndrome (OR 2.54, 95% CI: 1.54–4.19), excessive alcohol consumption (OR 2.17, 95% CI: 1.32–3.56), meprobamate (OR 2.65, 95% CI: 1.12–6.25) and calcium channel blockers (OR 1.79, 95% CI: 1.16–2.76) were all risk factors for OH. In contrast, angiotensin receptor blockers (OR 0.52, 95% CI: 0.30–0.91) appeared to be protective factors against OH. This study demonstrates that a systematic investigation should be made in all elderly fallers and those at high risk of falls to detect the presence of OH. In OH patients, in addition to the usual predisposing factors, excessive alcohol consumption and psychotropic drug intake—in particular, the intake of serotonergic antidepressants—should be taken into account as potential risk factors.

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Acknowledgements

The authors would like to thank the IRA Group, Lille Faculty of Medicine, for their invaluable assistance and Mrs Marilyn Schreier for reviewing the English. This study has not received any external financing.

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Authors and Affiliations

  1. Gerontology Clinic, Les Bateliers Geriatric Hospital, Lille University Hospital, Lille, France

    C Gaxatte, O Lathuillerie, M-H Destailleur, E Boulanger & F Puisieux

  2. IRA Group, Lille Faculty of Medicine, University of Lille 2, Lille, France

    E Faraj

  3. Department of Biostatistics, CHRU Lille, EA2694, Univ Lille Nord de France, Lille, France

    J Salleron

  4. Neurology Department, EA1046, University of Lille 2, Lille University Hospital, Lille, France

    V Deramecourt

  5. Rehabilitation Clinic, Les Bateliers Geriatric Hospital, Lille University Hospital, Lille, France

    V Pardessus

  6. Biology of Aging, EA2693, University of Lille 2, Lille, France

    E Boulanger

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  1. C Gaxatte
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Correspondence to C Gaxatte.

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Gaxatte, C., Faraj, E., Lathuillerie, O. et al. Alcohol and psychotropic drugs: risk factors for orthostatic hypotension in elderly fallers. J Hum Hypertens 31, 299–304 (2017). https://doi.org/10.1038/jhh.2013.82

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