Signs
 

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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