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

• Published in: Journal of human hypertension Vol. 31; no. 4; pp. 299 - 304
• Main Authors: Gaxatte, C, Faraj, E, Lathuillerie, O, Salleron, J, Deramecourt, V, Pardessus, V, Destailleur, M-H, Boulanger, E, Puisieux, F
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-04-2017; Nature Publishing Group
• Subjects: 692/499; 692/700/1518; 692/700/565/1436; 692/700/565/2773; Accidental Falls; Aged; Aged, 80 and over; Alcohol; Alcohol Drinking - adverse effects; Alcohol use; Angiotensin; Antidepressants; Basal ganglia; Causes of; Central nervous system diseases; Complications and side effects; Demographic aspects; Drinking (Alcoholic beverages); Drinking of alcoholic beverages; Epidemiology; Falls (Accidents); Female; France - epidemiology; Health Administration; Health aspects; Humans; Hypotension; Hypotension, Orthostatic - chemically induced; Hypotension, Orthostatic - complications; Hypotension, Orthostatic - epidemiology; Loggers (Persons); Male; Medicine; Medicine & Public Health; Movement disorders; Multivariate analysis; Norepinephrine; original-article; Orthostatic hypotension; Patients; Population studies; Prevalence; Psychotropic drugs; Psychotropic Drugs - adverse effects; Public Health; Risk Factors; Serotonin uptake inhibitors; France; orthostatic hypotension; fall; alcohol consumption; risk factor; antidepressant; serotonin reuptake inhibitor
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/jhh.2013.82

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.