Loading...
Orthostatic hypotension can occur spontaneously in older people and may be aggravated by antihypertensive drug use. In this double-blind crossover study from Israel, researchers compared the orthostatic effects of an angiotensin-converting-enzyme inhibitor (enalapril; mean dose, 18 mg daily) and a calcium-channel blocker (long-acting nifedipine; mean dose, 55 mg daily) in 36 patients aged 65 or older with mild-to-moderate hypertension.
At baseline, mean systolic blood pressure was about 159 mm Hg when patients were supine and about 150 mm Hg after they were standing for 5 minutes. After 8 weeks of enalapril treatment, the mean 5-minute orthostatic fall in systolic BP was only 2 mm Hg (from 143 mm Hg supine to 141 mm Hg standing). In contrast…