In a patient with orthostatic hypotension, which drug class is typically evaluated for discontinuation?

• A. Angiotensin Receptor Blockers
• B. Beta-blockers
• C. Diuretics
• D. Calcium Channel Blockers

Answer: (B)

In the management of orthostatic hypotension, beta-blockers are often evaluated for discontinuation because they can exacerbate the condition. Orthostatic hypotension is characterized by a significant drop in blood pressure when a person stands up, which can lead to symptoms like dizziness and fainting.

Beta-blockers can lower heart rate and reduce the heart's contractility, which may be detrimental in patients who are already experiencing symptomatic drops in blood pressure upon standing. As a result, if a patient is experiencing orthostatic hypotension, clinicians may consider reducing or stopping beta-blocker therapy to help improve the patient's stability and mitigate symptoms.

In contrast, other classes like angiotensin receptor blockers, diuretics, and calcium channel blockers may also contribute to hypotension, but beta-blockers are specifically noted for their direct impact on heart rate and blood pressure regulation that can set the stage for worsening orthostatic symptoms. Discontinuing or adjusting beta-blocker therapy is a common step to aid these patients.