Postural hypotension

Question 1

What is postural hypitension?

Answer 1

• A decrease in systolic blood pressure of 20mmHg or diastolic pressure of 10mmHg upon standing.

Question 2

What are the causes of postural hypotension?

Answer 2

• Meds: vasodilators, diuretics, negative ionotropes, antidepressants, antihypertensives and opioids.
• Chronic hypertension (due to loss of baroreceptor reflex)
• Dehydration
• Sepsis,
• Autonomic nervous system dysfunction eg, Parkinson’s or diabetes.
• Adrenal insufficiency

Question 3

What are the signs and symptoms of postural hypotension?

Answer 3

• Dizziness,
• Syncope,
• Falls,
• Fractures,
• more frequently occurs after meals or exercise, warm encironments

Question 4

what are the differential diagnosis of postural hypotension?

Answer 4

• Vertigo
• Hypoglycaemia
• Arrhythmias

Question 5

what are the investigations for postural hypotension?

Answer 5

Lying and standing BP

Question 6

What’s the management of postural hypotension?

Answer 6

• Ensuring adequate hydration,
• Evaluate meds,
• Recommend compression stockings
• midodrine (when autonomic dysfunction is the cause) or fludrocortisone