{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:05:43Z","timestamp":1792191943234,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000377","name":"Dunhill Medical Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Over 250 medications are reported to cause orthostatic hypotension, associated with serious adverse outcomes in older adults. Studies suggest a harmful cumulative risk of orthostatic hypotension with multiple medication use. However, there is limited evidence on the potential for harm in practice, particularly which drugs is co\u2010prescribed and may increase risk of orthostatic hypotension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study and cluster analysis using general practice data from IQVIA Medical Research Data (IMRD) in patients aged \u226550 contributing data between 1 January 2018 and 31 December 2018. Thirteen drug groups known to be associated with orthostatic hypotension by mechanism, were analyzed and clusters generated by sex and age\u2010band.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 602\u2009713 individuals aged \u226550 with 283\u2009912 (47%) men and 318\u2009801 (53%) women were included. The most prevalent prescriptions that might contribute to orthostatic hypotension were ACE inhibitors, calcium\u2010channel blockers, beta\u2010blockers, selective serotonin reuptake inhibitors and uroselective alpha\u2010blockers. We identified distinct clusters of cardiovascular system (cardiovascular system) drugs in men and women at all ages. cardiovascular system plus psychoactive drug clusters were common in women at all ages, and in men aged \u226470. cardiovascular system plus uroselective alpha\u2010blockers were identified in men aged \u226570.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Distinct clusters of drugs associated with orthostatic hypotension exist in practice, which change over the life course. Our findings highlight potentially harmful drug combinations that may cause cumulative risk of orthostatic hypotension in older people. This may guide clinicians about the potential of synergistic harm and to monitor for orthostatic hypotension if using combinations of cardiovascular system drugs, cardiovascular system plus psychoactive drugs and\/or alpha\u2010blockers\u2014particularly in patients aged \u226570 or at high\u2010risk due to comorbidity. Future research should consider quantifying the risk of drug\u2010induced orthostatic hypotension with such drug combinations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5730","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T08:35:58Z","timestamp":1700210158000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Drug\u2010induced orthostatic hypotension: Cluster analysis of co\u2010prescription patterns in older people in <scp>UK<\/scp> primary care"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-4172","authenticated-orcid":false,"given":"Cini","family":"Bhanu","sequence":"first","affiliation":[{"name":"Research Department of Primary Care and Population Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Petersen","sequence":"additional","affiliation":[{"name":"Research Department of Primary Care and Population Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mine","family":"Orlu","sequence":"additional","affiliation":[{"name":"University College London (UCL) School of Pharmacy  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Davis","sequence":"additional","affiliation":[{"name":"MRC Unit for Lifelong Health &amp; Ageing University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reecha","family":"Sofat","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Therapeutics University of Liverpool  Liverpool UK"},{"name":"British Heart Foundation, Data Science Centre  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Bazo\u2010Alvarez","sequence":"additional","affiliation":[{"name":"Research Department of Primary Care and Population Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Walters","sequence":"additional","affiliation":[{"name":"Research Department of Primary Care and Population Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286\u2010011\u20100119\u20105"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n922"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266\u2010020\u201000796\u20105"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.05.079"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afw211"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002143"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/dtb.2020.000056"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102710.2005.00629.x[published"},{"key":"e_1_2_11_10_1","volume-title":"Blackouts.","author":"NICE Clinical Guidelines","year":"2021"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003821"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010019\u20100969\u20109"},{"key":"e_1_2_11_13_1","unstructured":"IQVIA. 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