Current pharmacological management of hypotensive syndromes in the elderly

Hypotensive syndromes are common among older adults. Symptomatic drop in blood pressure with standing, eating and head turning is very common in older adults. These conditions cause significant morbidity like dizziness, syncope and falls as well as a resultant decrease in function. Blood pressure dysregulation due to autonomic function abnormalities plays a role in causing these conditions. Non-pharmacological measures should be the first line of management, but it is not always sufficient for subjects with symptomatic hypotensive syndromes. Different medication groups have been shown to be useful. This article focuses mainly on the medication management of these conditions based on efficacy and tolerability evidence in the literature. Standard medication management recommendations based on evidence are lacking for many medications used in treating these hypotensive syndromes.