RESUMO
In a systematic study of orthostatic changes in blood pressure involving 200 unselected patients of an old people's home (mean of age: 80 years), an orthostatic fall in blood pressure, which was almost always moderate and with no detectable clinical consequences, was found in only 14% of patients. On the other hand an orthostatic increase in blood pressure, which still persisted 15 minutes after maintaining the upright position was observed in 55% of these cases. The proportion of cases in which an orthostatic increase in blood pressure was found was not essentially different in the 121 patients considered as normotensive in supine position (i.e. 59%) and in the 79 patients initially hypertensive (i.e. 48%). The occurrence of such an orthostatic hypertension in the elderly, particularly in those considered as normotensive, does not appear to have been reported previously, but such disorder is likely to be associated with underlying physiological changes. It may be related to arteriosclerotic changes in the arterial walls which, in connection with the ageing process, cause a decrease in baroreceptor sensitivity. It may also be assumed that marked and persisting orthostatic increase in blood pressure favors or worsens preexisting arterial lesions, particularly in the brain, and that in such cases appropriate adrenoceptor blocking therapy would therefore be justified.
