Orthostatic hypotension in elderly patients (case report)

Introduction. Orthostatic hypotension (OH) is a common problem in elderly people, characterized by a pathological decrease in blood pressure (BP) upon moving to an upright position and leading to weakness, dizziness, and syncope. Aim. To present a clinical case of OH in an elderly patient and discuss the features of diagnosis and treatment of OH in his patient category. Materials and methods. A clinical case of a 76-year-old patient with a history of cancer who was diagnosed with OH is described. A comprehensive examination was performed, including a passive orthostatic test (tilt table test). Results. During the orthostatic test, a decrease in systolic BP by 18 mmHg upon verticalization and impaired baroreflex sensitivity were revealed. Based on the discussion of the clinical case and a literature review, the features of management of elderly patients with OH were considered, including the need for an individual approach taking into account comorbidity, functional status, and the risk of adverse effects of therapy. Recommendations for non-pharmacological methods of OH correction and careful selection of medications when drug treatment is necessary are given. The importance of educating patients and their relatives about measures to prevent OH and associated complications is emphasized. Conclusion. Timely diagnosis and correction of OH in elderly patients are essential for preventing falls, injuries, and improving quality of life. Management of patients with OH requires a comprehensive approach, taking into account individual characteristics, and should include both non-pharmacological methods and rational pharmacotherapy.