An UK study found that bolus water drinking is superior to other nonpharmacological interventions for older people with orthostatic hypotension (OH). A total of 150 orthostatic challenges were performed in 25 older people (age 60–92 years). The response rate (of participants whose systolic blood pressure [SBP] drop improved by ≥10 mm Hg) to bolus water drinking was 56%, with standing SBP increasing by 12 mm Hg. Physical counter maneuvers were efficacious in 44% but had little effect on standing SBP (+7.5 mm Hg). Abdominal compression was efficacious in 52% and improved standing SBP (+10 mm Hg). Compression stockings were the least efficacious therapy (32%) and had little effect on standing SBP (+6 mm Hg). However, no intervention improved symptoms during standing. There were no adverse events. The findings suggests that bolus water drinking should be the standard first-line nonpharmacological intervention for older people with OH. Source: http://n.neurology.org/
