Combination non-pharmacologic intervention for orthostatic hypotension in older people: a phase 2 study.

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ID: 82838
2019
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Abstract
orthostatic hypotension (OH) is highly prevalent in older populations and is associated with reduced quality of life and increased mortality. Although non-pharmacologic therapies are recommended first-line, evidence for their use is lacking.determine the efficacy of combination non-pharmacologic therapy for OH in older people.a total of 111 orthostatic BP responses were evaluated in this prospective phase 2 efficacy study in 37 older people (≥60 years) with OH. Primary outcome was the proportion of participants whose systolic BP drop improved by ≥10 mmHg. Secondary outcomes include standing BP and symptoms. Comparison is made to the response rate of the most efficacious single therapy (bolus water drinking 56%). Therapeutic combinations were composed of interventions with known efficacy and tolerability: Therapy A- Bolus water drinking + physical counter-manoeuvres (PCM); Therapy B- Bolus water drinking + PCM + abdominal compression.the response rate to therapy A was 38% (95% confidence interval - CI 24, 63), with standing systolic BP increasing by 13 mmHg (95% CI 4, 22). Therapy B was efficacious in 46% (95% CI 31, 62), increasing standing systolic BP by 20 mmHg (95% CI 12, 29). Neither therapy had a significant effect on symptoms. There were no adverse events.in comparison to single therapy, there is little additional benefit to be gained from combination non-pharmacologic therapy. Focussing on single, efficacious therapies, such as bolus water drinking or PCM, should become standard first-line therapy.
Reference Key
frith2019combinationage Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Frith, James;Newton, Julia L;
Journal age and ageing
Year 2019
DOI
afz173
URL
Keywords
clinical trial older people orthostatic hypotension conservative treatment phase 2

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