postural hypotension

Question 1

definition

Answer 1

sustained reduction in systolic BP of at least 20mmHg, or diastolic BP of 10mmHg, that occurs within three minutes of standing.

Question 2

what normalises blood pressure

Answer 2

baroreceptors in the aortic arch and carotid sinus.

Question 3

neurogenic ph

Answer 3

insufficient release of noradrenaline due to autonomic dysfunction
T2DM
Parkinsons
SCLC

Question 4

non neurogenic

Answer 4

hypovolaemia, cardiac failure or venous pooling.

MI, dehydration
medications

Question 5

Common medications that can induce postural hypotension include the following:

Answer 5

Diuretics
Alpha-adrenoceptor blockers for prostatic hypertrophy
Antihypertensive drugs,
Insulin, levodopa, and tricyclic antidepressants can also cause vasodilation and postural hypotension in predisposed patients2

Question 6

symptoms

Answer 6

Dizziness
Weakness
Confusion
Blurred vision
Nausea
In severe cases, syncope.

Question 7

Exacerbating factors

Answer 7

Rising quickly after prolonged sitting or recumbency
Prolonged motionless standing
Time of day (early morning after nocturnal diuresis)
Dehydration
Physical exertion
Alcohol intake
Carbohydrate-heavy meals
Straining during micturition or defecation
Fever

Question 8

management

Answer 8

compression stockings and abdominal binders
counter manouvres like toe raising and leg elevation

fludrocortisone and midrodine