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Postural Hypotension

 
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Overview

Postural hypotension is present if there is a fall of >20mmHg systolic and >10mmHg diastolic blood pressure following standing.
  • How To Elicit

  • Measure the blood pressure with the patient lying down, and then remeasure it after the patient has been standing for one minute.
  • Causes of Postural Hypotension

  • Reduced intravascular volume - dehydration, haemorrhage
  • Autonomic dysfunction - diabetic neuropathy, vitamin B12 deficiency, hypothyroidism, parkinsonism, amyloidosis, paraneoplastic syndrome
  • Cardiac - congestive cardiac failure, cardiomyopathy, myocarditis, constrictive pericarditis, aortic stenosis
  • Endocrine - Addison's disease, phaeochromocytoma
  • Drugs - nitrates, anticholinergics, antidepressants, antihypertensives, levodopa
  • Prolonged bed rest
  • Alcohol
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