Which medication class is listed in Beers Criteria as potentially causing orthostatic blood pressure changes?

• A. Acetylcholinesterase Inhibitors
• B. Beta blockers
• C. ACE inhibitors
• D. Statins

Answer: (A)

Beers Criteria flags certain medications in older adults because they can raise the risk of orthostatic hypotension and, as a result, falls. Acetylcholinesterase inhibitors, which are used for dementia, can increase parasympathetic (vagal) activity. This can slow the heart and blunt the body’s normal reflexes that raise blood pressure when you stand. In someone older, with potential dehydration or vascular changes, this can lead to dizziness or lightheadedness upon standing, i.e., orthostatic BP changes. So, among the options, this class is the one Beers Criteria highlights for orthostatic hypotension risk. If starting or increasing this medication, monitor blood pressure changes when moving to a standing position and watch for symptoms like dizziness or fainting.