User:Mr. Ibrahem/Orthostatic hypotension
Medical condition / From Wikipedia, the free encyclopedia
Orthostatic hypotension, also known as postural hypotension, is a sudden decrease in blood pressure when standing up.[1] Symptoms may include rapid onset of lightheadedness, blurry vision, confusion, and syncope with standing.[1][3] It is associated with an increased risk of falls, heart disease, and death.[2]
Orthostatic hypotension | |
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Other names | Orthostasis, postural, positional hypotension, neurogenic orthostatic hypotension |
A person developing syncope post standing up | |
Specialty | Cardiology, neurology |
Symptoms | Lightheadedness with standing[1] |
Complications | Falls, heart disease[2] |
Types | Acute, chronic[3] Neurogenic, non-neurogenic[2] |
Causes | Decreased blood volume, certain medications, prolonged bed rest, autonomic neuropathy, multiple system atrophy[4][1] |
Diagnostic method | Blood pressure lying and standing, tilt-table test[2] |
Differential diagnosis | Anemia, arrhythmia, heart failure, diabetes insipidus[5] |
Treatment | Decreasing certain medications, physiotherapy, compression stockings, salt and water intake[1] |
Medication | Midodrine, droxidopa, fludrocortisone[2] |
Prognosis | Depends on cause[1] |
Frequency | Common[2] |
Causes include decreased blood volume; medications such as beta-blockers, tricyclic antidepressants, and alpha blockers; prolonged bed rest; autonomic neuropathy; Addison disease; and multiple system atrophy.[4][1][3] The underlying mechanism often involves insufficient compensation to pooling of blood in the legs with standing.[3] It is defined as a drop in systolic blood pressure of at least 20 mmHg or diastolic blood pressure of at least 10 mmHg with standing.[2] It is classified into neurogenic and non-neurogenic causes.[2]
Treatment involves addressing the underlying cause.[1] This may involve decreasing certain medications, physiotherapy, wearing compression stockings, increase salt and water intake, or medications such as midodrine.[1] Orthostatic hypotension is common, particularly among older people.[2] Over half of older people in care homes are affected.[2] It is the cause of many falls in older people.[3]