Postural hypotension:

Question 1

What does postural hypotension count as in terms of blood pressure readings?

Answer 1

Systolic - fall >20mmHg

Diastolic - fall >10mmHg

Associated with dizzyness, head rush, syncope

Question 2

Give 4 RF for postural hypotension:

Answer 2

• Elderly
• Autonomic neuropathy
• On antihypertensives (ACEi, ARB, CCB)
• Over-diuresis (furosemide, thiazides)

Question 3

Where are baroreceptors present?

Answer 3

Carotid sinus (CN IX: glossopharyngeal)

Aortic arch (CN V: vagus)

Question 4

Outline the mechanism by which baroreceptors work:

Answer 4

When BP falls -> vessles relax -> stimulation of sympathetic activation -> vasoconstriction + ^ HR = ^ BP

Question 5

What diseases can cause decrease in BP?

Answer 5

• Addisons
• Phaechromocytoma
• Parkinsons

Question 6

Give 3 medications that can cause postural hypotension:

Answer 6

• Viagra
• TCA (amitriptyline)
• MAOI (phenelzine)

Question 7

What is the management of postural hypotension?

Answer 7

• Avoid falling (sit down)
• Increase venous return: legs crossed, squatting, calf compression stockings
  RX:
• Fludrocortisone (fluid retention)
• Ephedrine (sympathomimetics

Question 8

What causes increase in blood pressure?

Answer 8

Sympathetic activation