Orthostatic Hypotension: Difference between revisions
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== Definition == | == Definition == | ||
Orthostatic hypotension is defined as a sudden drop in blood pressure upon standing from a sitting or supine position. Diagnosis is made if the blood pressure drops by or greater 20mmHg systolically and 10mmHg diastolically. This occurs within three minutes of standing after being supine for 5 minutes or at 60% angle on a tilt table. This sudden drop in blood pressure is due to failure of autonomic reflex, volume depletion, or adverse reaction to medication. Symptoms on presentation are commonly related to reduced blood flow to the brain but many patients can be asymptomatic. Frequent falls occur due to this disease process resulting in a high rate of morbitity and mortality and multiple hospital admissions.<ref>Ringer M, Lappin SL. [https://www.ncbi.nlm.nih.gov/books/NBK448192/ Orthostatic Hypotension]. InStatPearls [Internet] 2017 Oct 4. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448192/ (last accessed 1.4.2019)</ref> | Orthostatic hypotension is defined as a sudden drop in blood pressure upon standing from a sitting or supine position. Diagnosis is made if the blood pressure drops by or greater 20mmHg systolically and 10mmHg diastolically. This occurs within three minutes of standing after being supine for 5 minutes or at 60% angle on a tilt table. This sudden drop in blood pressure is due to failure of autonomic reflex, volume depletion, or adverse reaction to medication. Symptoms on presentation are commonly related to reduced blood flow to the brain but many patients can be asymptomatic. Frequent falls occur due to this disease process resulting in a high rate of morbitity and mortality and multiple hospital admissions.<ref name=":0">Ringer M, Lappin SL. [https://www.ncbi.nlm.nih.gov/books/NBK448192/ Orthostatic Hypotension]. InStatPearls [Internet] 2017 Oct 4. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448192/ (last accessed 1.4.2019)</ref> | ||
{{#ev:youtube|https://www.youtube.com/watch?v=SLbkF_k6rj4|width}}<ref>World medical school. Orthostatic hypotension. Available from: https://www.youtube.com/watch?v=SLbkF_k6rj4 (last accessed 1.4.2019)</ref> | {{#ev:youtube|https://www.youtube.com/watch?v=SLbkF_k6rj4|width}}<ref>World medical school. Orthostatic hypotension. Available from: https://www.youtube.com/watch?v=SLbkF_k6rj4 (last accessed 1.4.2019)</ref> | ||
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== Etiology == | == Etiology == | ||
Orthostatic hypotension etiology can be caused by | Orthostatic hypotension etiology can be caused by | ||
* Neurogenic. See video clip below | * Neurogenic. This occurs due to autonomic instability secondary to neuropathic disease, neurodegenerative disease, or aging eg [[Diabetes]], [[Lewy Body Disease|Lewy]] body dementia, Demyelinating diseases, [[Huntington Disease|Huntington's]], [[Parkinson's Disease|Parkinson's]], [[Multiple System Atrophy|MSA]]. See video clip below. | ||
{{#ev:youtube|https://www.youtube.com/watch?v=6LcX7fGaUe0&t=215s|width}}<ref>TreatneurogenicOHnow. Neurogenic orthostatic hypotension. Available from: https://www.youtube.com/watch?v=6LcX7fGaUe0&t=215s (last accessed 1.4.2019)</ref> | {{#ev:youtube|https://www.youtube.com/watch?v=6LcX7fGaUe0&t=215s|width}}<ref>TreatneurogenicOHnow. Neurogenic orthostatic hypotension. Available from: https://www.youtube.com/watch?v=6LcX7fGaUe0&t=215s (last accessed 1.4.2019)</ref> | ||
* Non neurogenic | * Non neurogenic. Volume depletion eg Dehydration, Hyperglycemia, Hemorrhage, Vomiting. | ||
* Medication related | * [[Medication and Falls|Medication]] related. eg vasodilators, diuretics, antidepressants, antipsychotics and dopaminergic drugs , polypharmacy.<ref name=":0" /> | ||
== Clinical Presentation == | == Clinical Presentation == | ||
Revision as of 08:07, 1 April 2019
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Definition[edit | edit source]
Orthostatic hypotension is defined as a sudden drop in blood pressure upon standing from a sitting or supine position. Diagnosis is made if the blood pressure drops by or greater 20mmHg systolically and 10mmHg diastolically. This occurs within three minutes of standing after being supine for 5 minutes or at 60% angle on a tilt table. This sudden drop in blood pressure is due to failure of autonomic reflex, volume depletion, or adverse reaction to medication. Symptoms on presentation are commonly related to reduced blood flow to the brain but many patients can be asymptomatic. Frequent falls occur due to this disease process resulting in a high rate of morbitity and mortality and multiple hospital admissions.[1]
Etiology[edit | edit source]
Orthostatic hypotension etiology can be caused by
- Neurogenic. This occurs due to autonomic instability secondary to neuropathic disease, neurodegenerative disease, or aging eg Diabetes, Lewy body dementia, Demyelinating diseases, Huntington's, Parkinson's, MSA. See video clip below.
- Non neurogenic. Volume depletion eg Dehydration, Hyperglycemia, Hemorrhage, Vomiting.
- Medication related. eg vasodilators, diuretics, antidepressants, antipsychotics and dopaminergic drugs , polypharmacy.[1]
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions[edit | edit source]
add text here relating to management approaches to the condition
Differential Diagnosis[edit | edit source]
add text here relating to the differential diagnosis of this condition
Resources[edit | edit source]
add appropriate resources here
References[edit | edit source]
- ↑ 1.0 1.1 Ringer M, Lappin SL. Orthostatic Hypotension. InStatPearls [Internet] 2017 Oct 4. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448192/ (last accessed 1.4.2019)
- ↑ World medical school. Orthostatic hypotension. Available from: https://www.youtube.com/watch?v=SLbkF_k6rj4 (last accessed 1.4.2019)
- ↑ TreatneurogenicOHnow. Neurogenic orthostatic hypotension. Available from: https://www.youtube.com/watch?v=6LcX7fGaUe0&t=215s (last accessed 1.4.2019)
