[Orthostatic syndrome in old age. Frequency and therapy (author's transl)]

Largely confirmed Caird's figures. Using Schellong's test we recorded systolic pressure falls of 20 mm Hg and more in 25% of 160 residents in an old people's home in the age range 59-88 years. These cases of circulatory dysregulation were all manifestations of the hypodynamic form of the orthostatic syndrome. This means that only systolic blood pressure fell, diastolic pressure as well as heart rate being largely unaffected. The phenomenon appears to be due to age-related deterioration in circulatory regulation; at least no evidence has been found to suggest that it has a specific aetiology. In a double-blind cross-over study the effect of dihydroergotamine (DHE) was compared to placebo in 40 patients. Half the patients were given 2 mg DHE three times daily for 14 days and the other half placebo tablets; following one week's wash-out, the treatments were then reversed for a further 2-week period. Schellong's test (measurement of blood pressure and pulse after 10 minutes in the supine position and then after 1, 2, 5 and 10 minutes standing) was performed at the beginning and end of each treatment period. The average falls in upright systolic pressure for all 40 patients were as follows: before treatment 20 mm Hg, end of placebo periods 19 mm Hg, end of DHE periods 7 mm Hg. The differences between the values recorded after treatment with DHE and the other 2 values are statistically significant.