Orthostatic hypotensive reactions in elderly and senile patients with arterial hypertension

It is known that the frequency of orthostatic hypotensive reactions (OHR) increases with age and is often found in elderly and senile people with arterial hypertension (AH), negatively affecting their quality of life. A large number of studies indicate an association of OHR with an increased risk of cardiovascular complications, cognitive impairment and mortality, especially for middle-aged and elderly people (up to 65 years). The prognostic role of OHR for older patients with AH is currently uncertain. In addition, there are still a number of unresolved issues regarding the detection of OHR in this category of patients and the determination of treatment tactics. This review presents a modern classification of orthostatic hypotensive reactions and features of their clinical manifestations in elderly patients with AH. Particular attention is paid to the analysis of the results of studies on the prognostic role of OHR in hypertension patients in increasing the risk of developing coronary and cerebrovascular complications and cognitive impairments. The features of antihypertensive therapy in hypertensive patients with OHR are considered, as well as modern recommendations on drug and non-drug methods of treatment of OHR are presented.