دورية أكاديمية
أعرض في EDS

Orthostatic blood pressure recovery in older males using alpha-blockers for lower urinary tract symptoms, an explorative study in a urology outpatient clinic.

التفاصيل البيبلوغرافية
العنوان: Orthostatic blood pressure recovery in older males using alpha-blockers for lower urinary tract symptoms, an explorative study in a urology outpatient clinic.
المؤلفون: Spies PE; Dept. of Geriatric Medicine, Gelre Ziekenhuizen, Apeldoorn & Zutphen, Zutphen, The Netherlands.; Centre of Excellence for Old Age Medicine, Gelre ziekenhuizen, Apeldoorn & Zutphen, Zutphen, The Netherlands., Beune TNN; Dept. of Geriatric Medicine, Gelre Ziekenhuizen, Apeldoorn & Zutphen, Zutphen, The Netherlands.; Centre of Excellence for Old Age Medicine, Gelre ziekenhuizen, Apeldoorn & Zutphen, Zutphen, The Netherlands., Heesakkers J; Dept. of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands., van Munster BC; Centre of Excellence for Old Age Medicine, Gelre ziekenhuizen, Apeldoorn & Zutphen, Zutphen, The Netherlands.; Department of Internal Medicine and Geriatrics, Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands., Claassen JAHR; Dept. of Geriatric Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
المصدر: Journal of clinical pharmacy and therapeutics [J Clin Pharm Ther] 2022 Oct; Vol. 47 (10), pp. 1698-1703. Date of Electronic Publication: 2022 Jul 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Country of Publication: England NLM ID: 8704308 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2710 (Electronic) Linking ISSN: 02694727 NLM ISO Abbreviation: J Clin Pharm Ther Subsets: MEDLINE
أسماء مطبوعة: Publication: Oxford : Wiley-Blackwell Pub.
Original Publication: Oxford : Blackwell Scientific Publications, c1987-
مواضيع طبية MeSH: Hypotension, Orthostatic*/diagnosis , Hypotension, Orthostatic*/drug therapy , Hypotension, Orthostatic*/epidemiology , Lower Urinary Tract Symptoms*/complications , Lower Urinary Tract Symptoms*/drug therapy , Lower Urinary Tract Symptoms*/epidemiology , Urology*, Aged ; Aged, 80 and over ; Ambulatory Care Facilities ; Blood Pressure ; Cross-Sectional Studies ; Humans ; Male
مستخلص: What Is Known and Objective: Alpha-blockers have been associated with orthostatic hypotension (OH). We aimed to assess the prevalence of OH measured with beat-to-beat blood pressure monitoring in older male outpatients who used alpha-blockers for lower urinary tract symptoms (LUTS). In addition, we investigated associations of OH with duration of alpha-blocker use, concomitant medication use and comorbidity.
Methods: Cross-sectional explorative study in a urology outpatient clinic. Older white males ≥65 years using alpha-blockers for LUTS were included. Blood pressure responses to standing up from supine were recorded using a validated beat-to-beat blood pressure device (Finapres). Prevalence rates were derived from the beat-to-beat data to include OH measured between 60-110 s (OH), impaired recovery OH at 40 s (OH[40]), initial OH (IOH) and normal orthostatic response. Subgroups were defined based on duration of alpha-blocker use, polypharmacy, and Charlson comorbidity index (CCI), to obtain relative risks.
Results and Discussion: Sixty-five patients were included. Median age was 75 years (range 65-92). The prevalence of OH was 7.7% (n = 5). The prevalence of OH(40) was 16.9% (n = 11) and of IOH 38.5% (n = 25). Thirty-six patients (55.4%) had a normal orthostatic response. The relative risk of OH for the subgroup using ≥ 10 medications (n = 13) was 6.0 (95%CI 1.1-32.3). For the subgroup with multimorbidity (CCI ≥3, n = 11) this was 7.4 (95%CI 1.4-39.0). Recent initiation of alpha-blocker use (<3 months) did not increase OH risk (RR 0.6 [95%CI 0.1-5.1]).
What Is New and Conclusion: The overall prevalence of OH was low and comparable to age-matched population prevalence, suggesting that the relative contribution of alpha-blockers to OH was small. However, OH risk significantly increased in patients with multimorbidity or polypharmacy. For these patients, the benefits of starting alpha-blockers for LUTS should be weighed against the increased risk of OH.
(© 2022 John Wiley & Sons Ltd.)
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فهرسة مساهمة: Keywords: LUTS; multimorbidity; orthostatic hypotension; polypharmacy; side effect
تواريخ الأحداث: Date Created: 20220701 Date Completed: 20221006 Latest Revision: 20221006
رمز التحديث: 20231215
DOI: 10.1111/jcpt.13726
PMID: 35777069
قاعدة البيانات: MEDLINE
الوصف
تدمد:1365-2710
DOI:10.1111/jcpt.13726