{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:03:13Z","timestamp":1785542593143,"version":"3.56.0"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>orthostatic hypotension (OH) is highly prevalent in older populations and is associated with reduced quality of life and increased mortality. Although non-pharmacologic therapies are recommended first-line, evidence for their use is lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>determine the efficacy of combination non-pharmacologic therapy for OH in older people.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>a total of 111 orthostatic BP responses were evaluated in this prospective phase 2 efficacy study in 37 older people (\u226560\u00a0years) with OH. Primary outcome was the proportion of participants whose systolic BP drop improved by \u226510\u00a0mmHg. Secondary outcomes include standing BP and symptoms. Comparison is made to the response rate of the most efficacious single therapy (bolus water drinking 56%). Therapeutic combinations were composed of interventions with known efficacy and tolerability: Therapy A- Bolus water drinking + physical counter-manoeuvres (PCM); Therapy B- Bolus water drinking + PCM\u2009+\u2009abdominal compression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>the response rate to therapy A was 38% (95% confidence interval \u2013 CI 24, 63), with standing systolic BP increasing by 13\u00a0mmHg (95% CI 4, 22). Therapy B was efficacious in 46% (95% CI 31, 62), increasing standing systolic BP by 20\u00a0mmHg (95% CI 12, 29). Neither therapy had a significant effect on symptoms. There were no adverse events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>in comparison to single therapy, there is little additional benefit to be gained from combination non-pharmacologic therapy. Focussing on single, efficacious therapies, such as bolus water drinking or PCM, should become standard first-line therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afz173","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T15:07:31Z","timestamp":1576508851000},"page":"253-257","source":"Crossref","is-referenced-by-count":14,"title":["Combination non-pharmacologic intervention for orthostatic hypotension in older people: a phase 2 study"],"prefix":"10.1093","volume":"49","author":[{"given":"James","family":"Frith","sequence":"first","affiliation":[{"name":"Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"},{"name":"The Falls and Syncope Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK"},{"name":"NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Trust and Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia L","family":"Newton","sequence":"first","affiliation":[{"name":"Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"},{"name":"The Falls and Syncope Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK"},{"name":"NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Trust and Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"2020022808594068600_ref1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s10286-011-0119-5","article-title":"Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome","volume":"21","author":"Freeman","year":"2011","journal-title":"Clin Auton Res"},{"key":"2020022808594068600_ref2","doi-asserted-by":"crossref","first-page":"e652","DOI":"10.1212\/WNL.0000000000005994","article-title":"The efficacy of nonpharmacologic intervention for orthostatic hypotension associated with aging","volume":"91","author":"Newton","year":"2018","journal-title":"Neurology"},{"key":"2020022808594068600_ref3","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1186\/s12877-018-0999-5","article-title":"Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative study","volume":"18","author":"Robinson","year":"2018","journal-title":"BMC Geriatrics"},{"key":"2020022808594068600_ref4","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/joim.12249","article-title":"Physical countermeasures to increase orthostatic tolerance","volume":"277","author":"Wieling","year":"2015","journal-title":"J Intern Med"},{"key":"2020022808594068600_ref5","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.apmr.2014.10.012","article-title":"Effects of patient-controlled abdominal compression on standing systolic blood pressure in adults with orthostatic hypotension","volume":"96","author":"Figueroa","year":"2015","journal-title":"Arch Phys Med Rehabil"},{"key":"2020022808594068600_ref6","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1161\/01.CIR.101.5.504","article-title":"The pressor response to water drinking in humans: a sympathetic reflex?","volume":"101","author":"Jordan","year":"2000","journal-title":"Circulation"},{"key":"2020022808594068600_ref7","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s10286-011-0146-2","article-title":"The orthostatic hypotension questionnaire (OHQ): validation of a novel symptom assessment scale","volume":"22","author":"Kaufmann","year":"2012","journal-title":"Clin Auton Res"},{"key":"2020022808594068600_ref8","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1002\/sim.721","article-title":"Sample size tables for exact single-stage phase II designs","volume":"20","author":"A'Hern","year":"2001","journal-title":"Stat Med"},{"key":"2020022808594068600_ref9","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s00228-017-2388-y","article-title":"Measuring medication adherence in older community-dwelling patients with multimorbidity","volume":"74","author":"Kim","year":"2018","journal-title":"Eur J Clin Pharmacol"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/49\/2\/253\/32677979\/afz173.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/49\/2\/253\/32677979\/afz173.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T08:59:51Z","timestamp":1582880391000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/49\/2\/253\/5685756"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,23]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,12,23]]},"published-print":{"date-parts":[[2020,2,27]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afz173","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,3]]},"published":{"date-parts":[[2019,12,23]]}}}