5-minute Fellowships: Dr Cini Bhanu – The biggest culprits of drug-induced postural hypotension in older adults

As a GP, Cini saw how older people taking an increasing list of medications often had postural hypotension – a drop in blood pressure on standing up – which can lead to dizziness, falls, strokes and cognitive decline. Her Research Training Fellowship  investigated which medications, or combination of medications, are the most common  culprits for postural hypotension. 

Using the Health Improvement Network (THIN) database, Cini found that medications causing sympathetic inhibition in autonomic nervous responses are far more likely to cause profound hypotension. This includes drugs like beta blockers, alpha blockers and some anti-psychotics. Interestingly, vasodilation drugs – traditionally considered to induce postural hypotension – were shown to not cause a problem. Next, Cini is working on improving how GPs code for the condition in primary care records. It is expected that 20-30% of people over 65  have postural hypotension – yet less than 1% of older people have it recorded making it harder for clinicians to help their patients manage this condition.