Beta-blockers and tricyclic antidepressants are more commonly associated with orthostatic hypotension

Question clinique

What medications are associated with orthostatic hypotension?

L’Essentiel

Beta-blockers — but not calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin-receptor blockers — were associated with a 7-fold increase in the likelihood of causing OH as compared with placebo. Tricyclic antidepressants — but not selective serotonin receptor inhibitors — were associated with a similar increase. Second-generation antipsychotics were associated with an increased risk, as were SGLT-2 inhibitors used to treat type 2 diabetes. Of course, this meta-analysis could only include studies in which OH was tested and also reported, and the included studies largely excluded older patients who might be more prone (to OH) when not prone. 1a

Plan de l'etude: Meta-analysis (other)

Financement: Foundation

Cadre: Various (meta-analysis)

Reviewer

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA


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Commentaires

Kenneth Paul William Buchholz

b-blockers and TCAs both contribute to syncope

both are on Beer's criteria, and so should be used with caution.

Anonymous

B-Blockers and OH

As OH is more common in the 'elderly', their exclusion is non-understandable

Dante Eliseo Manyari

important

Important and relevant observation that will benefit many patients

Anonymous

oh big problem

other drugs

Anonymous

drugs causing OH

betablockers 7 x more likely and tricycyclics