Geriatrics
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Orthostatic hypotension (OH), defined as a decline in blood pressure when a person moves from a supine to sitting or standing position, is a common physical finding in the primary care setting. It is associated with several medical conditions and its prevalence increases with age. Treatment is specific to cause. ⋯ OH secondary to autonomic insufficiency or neurogenic causes remains a challenge to manage, and a combination of non-pharmacologic and pharmacologic measures are needed. Recommendations are made for preventive measures, patient and caregiver education, and nonpharmacologic and pharmacologic approaches to treatment. Approaches to managing OH in conjunction with hypertension are also discussed.
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Cardiovascular disease is prevalent in the older population, making older patients susceptible to complications, including cardiac arrest. Early intervention via cardiopulmonary resuscitation or another form of emergency cardiovascular care can reduce mortality in this population. ⋯ By understanding these ACLS recommendations, primary care physicians will be better prepared to assist their older patients during a cardiac emergency. In the geriatric population, awareness of the patients' wishes regarding initiation of cardiopulmonary resuscitation is important in deciding if it is appropriate to proceed with these measures.