User:Mr. Ibrahem/Orthostatic hypotension
| Orthostatic hypotension | |
|---|---|
| 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] |
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]
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]
References[edit]
- ^ a b c d e f g h i "Orthostatic Hypotension Information Page | National Institute of Neurological Disorders and Stroke". www.ninds.nih.gov. Archived from the original on 4 November 2021. Retrieved 10 March 2022.
- ^ a b c d e f g h i j Arnold, AC; Raj, SR (December 2017). "Orthostatic Hypotension: A Practical Approach to Investigation and Management". The Canadian journal of cardiology. 33 (12): 1725–1728. doi:10.1016/j.cjca.2017.05.007. PMID 28807522.
- ^ a b c d e "Orthostatic Hypotension - Cardiovascular Disorders". Merck Manuals Professional Edition. Archived from the original on 9 February 2022. Retrieved 10 March 2022.
- ^ a b Bhanu, C; Nimmons, D; Petersen, I; Orlu, M; Davis, D; Hussain, H; Magammanage, S; Walters, K (November 2021). "Drug-induced orthostatic hypotension: A systematic review and meta-analysis of randomised controlled trials". PLoS medicine. 18 (11): e1003821. doi:10.1371/journal.pmed.1003821. PMID 34752479.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Ringer, Matthew; Lappin, Sarah L. (2022). "Orthostatic Hypotension". StatPearls. StatPearls Publishing.