Orthostatic hypotension (OH) is often reported as a significant potential adverse effect of antidepressant use but the association between phasic blood pressure (BP) and antidepressants has not yet been investigated. This cross-sectional study compares continuously measured phasic BP and prevalence of OH in a cohort of antidepressant users ≥50 years compared with an age- and sex-matched cohort not taking antidepressants. OH was defined as a drop in systolic BP ≥ 20 mm Hg or in diastolic BP ≥ 10 mm Hg at 30 seconds after standing, measured using continuous beat-to-beat finometry. Multilevel time × group interactions revealed significantly greater systolic and diastolic BP drop in antidepressant users than nonusers at 30 seconds after stand. The prevalence of OH among antidepressant users was 31% (63/206), compared with 17% in nonusers (X² = 9.7; P = .002). Unadjusted logistic regression models demonstrated that selective serotonin reuptake inhibitor use was associated with OH at an odds ratio of 2.11 (95% confidence interval: 1.25–3.57); P = .005, and this association was not attenuated when covariates including cardiac disease and depressive symptom burden were added. There was no statistically significant association between serotonin noradrenaline reuptake inhibitor or tricyclic antidepressant use and OH in unadjusted models although the study was not powered to detect changes within these subgroups. Older people taking antidepressants have a two-fold higher prevalence of OH than nonusers, highlighting the importance of screening the older antidepressant user for OH and dizziness and rationalizing medications to reduce the risk of falls within this vulnerable cohort.

体位性低血压（OH）通常被报告为抗抑郁药的重大潜在不良反应，但尚未研究相血压（BP）和抗抑郁药之间的关联。这项横断面研究比较了年龄≥性别的未服用抗抑郁药的人群中，连续测量的≥50岁抗抑郁药人群中的相位血压和OH的患病率。OH被定义为站立后30秒收缩压BP≥20 mm Hg或舒张压BP≥10 mm Hg的下降，采用连续搏动式搏动式搏动量度法测量。多级时间×组交互作用显示，站立后30秒，抗抑郁药使用者的收缩压和舒张压BP下降比非使用者高得多。抗抑郁药使用者中OH的患病率为31％（63/206），而非使用者为17％（X ²  ＝ 9.7；P  = .002）。未经调整的逻辑回归模型表明，选择性5-羟色胺再摄取抑制剂的使用与OH相关，比值比为2.11（95％置信区间：1.25-3.57）。P = 0.005，当添加包括心脏病和抑郁症状负担在内的协变量时，这种关联性不会减弱。在未调整的模型中，5-羟色胺去甲肾上腺素再摄取抑制剂或三环类抗抑郁药的使用与OH之间无统计学意义的关联，尽管该研究无力检测这些亚组内的变化。服用抗抑郁药的老年人的OH患病率比不服用抗抑郁药的人高出两倍，这突出了筛查老年抗抑郁药使用者的OH和头晕的重要性，并合理化药物以降低跌入这一弱势人群的风险。