Effect of antihypertensives on risk of falls

Question 1

What are the 2 main pharmacological effects of antihypertensives?

Answer 1

Directly lower bp

Diminish vasoconstriction reflex

Question 2

Describe how vasoconstriction and gravitational stress are involved in causing postural hypotension?

Answer 2

Postural/orthostatic hypotension: Low blood pressure that occurs when person stands up suddenly, vasoconstriction won’t occur and gravitational stress causes blood will pool in veins of legs and trunk

Question 3

Give 3 symptoms of postural hypotension?

Answer 3

Dizziness
Fainting/syncope
Falls

Question 4

Why does postural hypotension cause more falls?

Answer 4

Blood pools in veins of legs and trunks and is pumped at low bp, so less is pumped to organs and muscles

Question 5

To diagnose postural hypotension, which 5 conditions should you screen for with a blood test?

Answer 5

Anaemia
B12 deficiency
Diabetes
Thyroid disease
Addison disease

Question 6

To diagnose postural hypotension, why should you do a echocardiogram?

Answer 6

to monitor heart’s pumping action

Question 7

To diagnose postural hypotension, why should you do a electrocardiogram?

Answer 7

test for heart rhythm changes

Question 8

What is the main special test to check for postural hypotension, and how is it performed?

Answer 8

Tilt table test

How heart rate, rhythm and blood pressure change as person moves from lying to standing position

Person is strapped to table lying down with arm cuff, table is slowly tilted until person is standing

Question 9

When monitoring a person’s blood pressure sitting and standing, describe the threshold bp drop values that indicate postural hypotension?

Answer 9

20mmHg drop in systolic pressure or 10mmHg drop in diastolic pressure

within 2-5 min