[Drug-induced orthostatic hypotension can be useful in antihypertensive therapy]

The evaluation of the efficacy of antihypertensive therapy may be misleading if it is based on office blood pressures which are usually higher than ambulatory or home pressures. An erroneous evaluation may also derive from the presence of orthostatic hypotension induced by antihypertensive therapy. In seven patients with moderate to severe hypertension who were treated with different antihypertensive agents and who presented drug-induced orthostatic hypotension we studied 24 hour blood pressures by means of the Oxford system. The mean of the blood pressures recorded with the patients up and about were lower than with the patients in the supine position. Consequently the physiological fall in blood pressure which is present in untreated patients during sleep was not observed. The following conclusions may be drawn: a) drug-induced orthostatic hypotension may be useful in antihypertensive therapy; b) drugs which are capable of reducing blood pressure particularly in the supine position should be preferred during the night; c) for the evaluation of antihypertensive therapy it is necessary to take into account both supine and standing blood pressure.