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Editor's Correspondence
May 26, 2003

Is Orthostatic Hypotension a Consistent Finding in the Acute Geriatric Ward?—Reply

Arch Intern Med. 2003;163(10):1240-1241. doi:10.1001/archinte.163.10.1239-a

In reply

Vloet and Jansen in their letter tried to differentiate between various kinds of BP drops among elderly patients: the one due to medications, the PPH, and the allegedly "pure" OH. They claim that we measured a combined BP effect of meals, medications, and postural changes. We agree that it is difficult to isolate the various contributors to the postural fall in BP, but one should keep in mind that what really matters and is deleterious to the patient is the overall magnitude of the orthostatic drop in BP. We therefore assessed the prevalence and consistency of OH throughout the day regardless of the reasons or the pathophysiology of that finding.1 The definition of OH was the basis of our measurement2 and in that definition no such differentiation had been made. We were certainly aware of the fact that this elderly population consumes many medications, some of which might have contributed to their OH.3