ABSTRACT
BACKGROUND: To determine if outpatient screening for orthostatic hypotension (OH) in the geriatric population results in fewer prescribed antihypertensive medications and if a relationship exists between OH and specific pharmacologic classes of antihypertensive medications. MATERIALS AND METHODS: Patients ≥ 65 years were screened for OH, defined as a decrease in systolic blood pressure (SBP)â ≥â 20â mm Hg or a decrease in diastolic blood pressure (DBP)â ≥â 10â mm Hg after standing for 3 minutes. Sitting blood pressure (BP) was measured after patients had been seated quietly in an exam room. Patients then stood for approximately 3 minutes at which time standing BP was recorded. RESULTS: OH prevalence was 18%. Standing DBP was significantly different between the two groups (70â mmHg ± 18, 80â mmHg ± 13, P â =â 0.007). Compared to patients without OH, patients with OH were more likely to have been previously prescribed beta-blockers (56% vs. 32%, P â =â 0.056) and potassium-sparing diuretics (11% vs. 1%, P â =â 0.026). Physicians discontinued an antihypertensive medication more often in patients who screened positive for OH than in to those who did not (17% vs. 4%, P â =â 0.037). Calcium channel blockers were the most frequently discontinued class of medication. CONCLUSION: Asymptomatic OH is prevalent in geriatric patients. Screening for OH may lead to de-escalation of antihypertensive regimen and a reduction in polypharmacy. Positive screening for OH was associated with de-prescribing of antihypertensive medications. Prior use of beta-blockers and potassium-sparing diuretics was most largely associated with OH.
Subject(s)
Hypertension , Hypotension, Orthostatic , Humans , Aged , Antihypertensive Agents/therapeutic use , Antihypertensive Agents/pharmacology , Blood Pressure/physiology , Hypertension/diagnosis , Hypertension/drug therapy , Hypertension/epidemiology , Hypotension, Orthostatic/diagnosis , Hypotension, Orthostatic/drug therapy , Hypotension, Orthostatic/epidemiology , Diuretics/therapeutic use , Primary Health Care , PotassiumABSTRACT
Various applications could benefit from new fluorinated molecules that offer chemical handles for quickly functionalizing reactive surfaces and molecules. Herein, we report the synthesis of a library of fluorinated molecules that contain nonafluoro-tert-butyl groups and electrophilic handles, mostly acrylates and acrylamides. Featuring a variety of hydrophobic and hydrophilic linkers, these molecules could find use in polymer chemistry, biomaterials, biomedical imaging, and protein tagging.
