{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:33:20Z","timestamp":1785432800153,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T00:00:00Z","timestamp":1528848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>To determine whether hypotensive drugs may play a pivotal role in inducing orthostatic hypotension (OH)\u2010related syncope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Prospective, observational, multicenter study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Acute care wards, syncope units, and centers for the diagnosis of dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>Individuals aged 65 and older with a diagnosis of dementia and 1 or more episodes of transient loss of consciousness of a suspected syncopal nature or unexplained falls during the previous 3 months<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>Blood pressure was measured in the supine position and in the orthostatic position after 1 and 3 minutes. OH was defined as a decrease in systolic blood pressure of 20 mmHg or more and in diastolic blood pressure of 10 mmHg or more within 3 minutes of standing. Univariate and multivariate analyses were used to evaluate associations between hypotensive drugs and their combinations with OH\u2010related syncope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The mean age of the study population (n=522; women, n=324) was 83.5\u00b16.1, and the most frequent comorbidity was arterial hypertension (74.5%); 324 (67.8%) participants had had a syncopal fall and 168 (32.2%) a nonsyncopal fall. The mean number of hypotensive drugs administered (2.9\u00b13.1) did not differ between the two groups. Syncopal falls was OH\u2010related in 170 participants (48.0%). OH\u2010related syncopal falls were more frequent in participants receiving nitrates (15.3% vs 9.8%, p=.06), alpha\u2010blockers (16.5% vs 9.8%, p=.04), or combinations of angiotensin\u2010converting enzyme inhibitors (ACE\u2010Is) and diuretics (20.6% vs 13.0%, p=.04), alpha\u2010blockers and diuretics (8.2% vs 3.3%, p=0.036), and ACE\u2010Is and nitrates (8.2% vs 3.3%, p=.10). Multivariate analysis confirmed a greater risk of OH\u2010related syncopal fall for nitrates (relative risk (RR)=1.77), combinations of ACE\u2010Is and diuretics (RR=1.66), and combinations of ACE\u2010Is and nitrates (RR=2.32).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In older adults with dementia, OH\u2010related syncopal falls are significantly related to treatment with nitrates, combinations of ACE\u2010Is and diuretics, and combinations of ACE\u2010Is and nitrates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15421","type":"journal-article","created":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T06:15:35Z","timestamp":1528870535000},"page":"1532-1537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Hypotensive Drugs and Syncope Due to Orthostatic Hypotension in Older Adults with Dementia (Syncope and Dementia Study)"],"prefix":"10.1111","volume":"66","author":[{"given":"Gianluca","family":"Testa","sequence":"first","affiliation":[{"name":"Department of Translational Medical Sciences University of Naples, Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Ceccofiglio","sequence":"additional","affiliation":[{"name":"Syncope Unit, Geriatric Cardiology and Medicine University of Florence Florence Italy"},{"name":"Azienda Ospedaliero Universitaria Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Mussi","sequence":"additional","affiliation":[{"name":"Centro di Valutazione e Ricerca Gerontologica University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Bellelli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Milano Bicocca Milan Italy"},{"name":"Acute Geriatric Unit San Gerardo Hospital Monza Italy"},{"name":"Milan Center for Neuroscience Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Nicosia","sequence":"additional","affiliation":[{"name":"Medicine and Geriatric Unit Spedali Civili of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Bo","sequence":"additional","affiliation":[{"name":"SCDU Geriatria e Malattie Metaboliche dell'Osso Citt\u00e0 della Salute e della Scienza\u2010Molinette\u2010Torino Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Riccio","sequence":"additional","affiliation":[{"name":"Geriatric Department SS. 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