Postural Hypotension
March 28th, 2020
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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