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Heart. 1996 Dec;76(6):507-9.

Fludrocortisone in the treatment of hypotensive disorders in the elderly.

Author information

1
Cardiovascular Investigation Unit, Royal victoria Infirmary, Newcastle upon Tyne.

Erratum in

  • Heart 1997 Mar;77(3):294.

Abstract

OBJECTIVE:

To evaluate tolerance of fludrocortisone in older patients with hypotensive disorders.

DESIGN:

Prospective case series.

SETTING:

Syncope clinic.

PATIENTS:

64 Consecutive patients over 65 years (mean age 80 years) with one or more hypotensive disorders (orthostatic hypotension, vasodepressor carotid sinus syncope, and/or vasodepressor neurocardiogenic syncope.

INTERVENTIONS:

Fludrocortisone in daily doses of 100 micrograms [corrected] (72%), 50 micrograms [corrected] (27%), and 200 micrograms [corrected] (one patient).

MAIN OUTCOME MEASURES:

Adverse events, treatment withdrawal.

RESULTS:

During follow up 13 patients died of unrelated causes. Of the remainder 33% discontinued fludrocortisone at a mean of five months. Reasons for discontinuing treatment were hypertension, five; cardiac failure, four; depression, three; oedema, three; and unspecified, two. In those who continued treatment supine systolic and diastolic blood pressure did not differ significantly from baseline (follow up two to 21 months). Hypokalaemia developed in 24% at a mean of eight months; in no case was treatment withdrawn because of hypokalaemia.

CONCLUSION:

Fludrocortisone, even in low doses, is poorly tolerated in the long term in older patients with hypotensive disorders.

PMID:
9014799
PMCID:
PMC484603
[Indexed for MEDLINE]
Free PMC Article

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