[Orthostatic hypotension and its treatment in the elderly]

DEFINITION CRITERIA: Orthostatic hypotension (OH) is a frequent pathology in the elderly, defined, since the consensus meeting in 1996, as a drop in systolic blood pressure of > or = 20 mmHg and/or diastolic blood pressure of > or =10 mmHg, 1, 2 or 3 minutes after orthostatism. SEVERAL RISKS: Orthostatic hypotension is associated with the risk of falls and is a limiting factor in the patients' autonomy and quality of life. However, it is also an independent predictive factor of mortality, which should justify its fairly systematic research in the elderly. MULTIPLE CAUSES: Its multi-factor origin is enhanced by certain modifications related to age (autonomous nervous system, arterial wall), but above all by the numerous pathological situations and predominantly the iatrogenic disease, hypertension, or frequent situations in geriatrics such as anaemia and dehydration that must be systematically explored. THERAPEUTIC MEASURES: Its treatment relies on the elimination of the enhancing element, the patient's education, the wearing of elastic stockings and, at a later stage, administration of treatments such as midodrine.