Aging has become an important issue in Taiwan, dementia and medication problems are important issues among older people. Alzheimer's disease (AD) is a common cause of dementia. A new treatment in the form of the rivastigmine patch (Exelon®) is used to overcome deficits in the cholinergic system of patients with AD.We report a case of an uncommon adverse effect of high blood pressure caused by increasing dosage of cholinesterase inhibitor (ChEI) and postulated that ChEIs increase arterial blood pressure by acting through central muscarinic receptor type 1 and type 2. Attentions of rare side effects and treatment of unwanted complications are crucial after the prompt recognition of the symptoms or signs of hypertension induced by the rivastigmine patch.
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