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Dizziness in the elderly and calcium channel antagonists
C Le Jeunne1, F C Hugues, Y Munera
1Laboratoire de Thérapeutique Appliquée, Hôpital Laennec, Paris, France.
Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie
|January 1, 1991
Summary
Calcium channel antagonists can cause dizziness in elderly patients, especially when combined with diuretics. Orthostatic hypotension must be assessed before prescribing these hypertension drugs to seniors.
Area of Science:
- Gerontology
- Pharmacology
- Cardiovascular Medicine
Background:
- Calcium channel antagonists are generally safe for elderly hypertension treatment.
- Dizziness and malaise have been reported in elderly patients during initial treatment.
- Orthostatic hypotension and diuretic use are potential contributing factors.
Purpose of the Study:
- To investigate the blood pressure effects of calcium channel antagonists in elderly individuals.
- To evaluate the risk of hypotension associated with nicardipine in the elderly.
Main Methods:
- Observational study of five reported cases of malaise.
- Controlled study involving 10 elderly women (mean age 85) with normal blood pressure.
- Monitoring of systolic and diastolic blood pressure for 3 hours after a 20-mg oral dose of nicardipine.
Main Results:
- A significant drop in blood pressure was observed as early as 15 minutes post-administration, reaching up to 45% decrease.
- Even in a supine position, nicardipine caused substantial hypotension.
- Concomitant diuretic use increases the risk of hypovolemia and potentiates hypotension.
Conclusions:
- Orthostatic hypotension should be evaluated before initiating calcium channel antagonist therapy in the elderly.
- Combining calcium channel antagonists with diuretics poses a high risk due to potential hypovolemia.
- Careful patient selection and monitoring are crucial for safe calcium channel antagonist use in older adults.